Dopamine

Dopamine Brand Name– Intropin

What is Dopamine

Dopamine is an intravenous adrenergic agonist that mimics the actions of endogenous dopamine.

Endogenous dopamine is a neurotransmitter and is the metabolic precursor of norepinephrine and epinephrine.

The hemodynamic effects of dopamine are dose-dependent. Due to its potential for inotropic, chronotropic, and vasopressor effects, dopamine has several clinical uses.

Dopamine is indicated for the treatment of decreased cardiac output and hypotension associated with septic shock, cardiogenic shock, surgery, or acute myocardial failure. In adult patients with septic shock, dopamine is considered an alternate vasopressor to norepinephrine only in highly selected patients (e.g., those with low risk of tachyarrhythmias and absolute or relative bradycardia).

Dopamine may be used for patients with symptomatic bradycardia, particularly if associated with hypotension, in those whom atropine fails or is inappropriate.

In patients with sinus node dysfunction or second- or third-degree atrioventricular block associated with symptoms of hemodynamic compromise who are at a low likelihood of coronary ischemia, dopamine may be considered to increase heart rate, improve atrioventricular conduction, increase ventricular rate, and improve symptoms.

The routine use of low-dose dopamine for the treatment or prevention of acute renal failure is no longer recommended.

While low-dose dopamine infusions dilate renal arterioles and increase renal blood flow and glomerular filtration rate, clinical studies have not shown dopamine to be effective in the treatment of oliguric acute renal failure.

In addition, low-dose dopamine does not prevent acute renal failure in critically ill patients with early renal dysfunction.

Indications

1. bradycardia
2. cardiac arrest
3. cardiogenic shock
4. cardiopulmonary resuscitation
5. heart failure
6. hypotension
7. septic shock

Side Effects

1. angina
2. anxiety
3. arrhythmia exacerbation
4. atrial fibrillation
5. azotemia
6. bradycardia
7. dyspnea
8. gooseflesh
9. headache
10. hypertension
11. hypotension
12. injection site reaction
13. nausea
14. palpitations
15. peripheral vasoconstriction
16. premature ventricular contractions (PVCs)
17. sinus tachycardia
18. tissue necrosis
19. ventricular fibrillation
20. ventricular tachycardia
21. vomiting

Monitoring Parameters

• blood pressure
• heart rate

Contraindications

• abrupt discontinuation
• acute myocardial infarction
• angina
• asthma
• breast-feeding
• cardiac arrhythmias
• cardiac disease
• corn hypersensitivity
• coronary artery disease
• diabetes mellitus
• extravasation
• geriatric
• hypovolemia
• hypoxemia
• labor
• metabolic acidosis
• neonates
• obstetric delivery
• occlusive vascular disease
• peripheral vascular disease
• pheochromocytoma
• pregnancy
• Raynaud’s phenomenon
• respiratory acidosis
• sulfite hypersensitivity
• thromboangiitis obliterans (Buerger’s disease)
• ventricular fibrillation
• ventricular tachycardia

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