Dopamine

Question 1

Dopamine: Class

Answer 1

Sympathomimetic, inotropic agent

Question 2

Dopamine: Mechanism of Action

Answer 2

• Immediate metabolic precursor to Norepinephrine.
• Increases systemic vascular resistance, dilate renal and splanchnic vasculature.
• Increases myocardial contractility and stroke volume.

Question 3

Dopamine: Indications

Answer 3

• Cardiogenic, septic or spinal shock.
• Hypotension with low cardiac output states
• Distributive shock

Question 4

Dopamine: Contraindications

Answer 4

• Hypovolemic shock
• Pheochromocytoma
• Tachydysrhythmias
• VF

Question 5

Dopamine: Adverse Reactions

Answer 5

• Cardiac dysrhythmias
• Hypertension
• Increased myocardial oxygen demand
• Extravagation may cause tissue necrosis

Question 6

Dopamine: Drug Interactions

Answer 6

• Incompatible in alkaline solutions
• MAOIs will enhance effects of dopamine
• Beta blockers may antagonize effects of dopamine
• When administered with Phenytoin: may cause hypotension, bradycardia and seizures.

Question 7

Dopamine: How Supplied

Answer 7

• 200 mg / 5 ml - 400 mg / 5 ml prefilled syringes, ampules for IV infusion.
• 400 mg in 250 ml D5W premixed solutions.

Question 8

Dopamine: Dosage and Administration

Answer 8

• Adult: 2- 20 mcg / kg / min. (Rate determined by physician).
• Pediatric: 2 - 20 mcg / kg / min. (Rate determined by physician).

Question 9

Dopamine: Onset

Answer 9

1-4 Minutes

Question 10

Dopamine: Peak Effect

Answer 10

5-10 Minutes

Question 11

Dopamine: Duration

Answer 11

Effects cease almost immediately after infusion shut off.

Question 12

Dopamine: Pregnancy Class

Answer 12

Not established

Question 13

Dopamine: Special Considerations

Answer 13

Effects are dose-dependent

• Dopaminergic response: 2-4 mcg / kg / min.: dilates vessels in kidneys; inc. urine output.
• Beta-adrenergic response: 4-10 mcg / kg / min.: Increased chronotropy and inotropy
• Adrenergic response: 10-20 mcg / kg / min.: Primarily alpha stimulant / vasoconstriction.
• Greater than 20 mcg / kg / min.: reversal of renal effects / override alpha effects.
• Always monitor drip rate.
• Avoid extravagation injury.