Page 118 - 2026 SMOG

DOPAMINE (INTROPIN)
Class/Mechanism of Action
• Adrenergic Agonist; Inotrope; Vasopressor
Stimulates adrenergic and dopaminergic receptors. Low doses are mainly dopaminergic-stimulating
and produce renal and mesenteric vasodilation. High doses stimulate both dopaminergic and beta -
1
adrenergic receptors, producing cardiac stimulation and renal vasodilation. Large doses stimulate
alpha-adrenergic receptors.
˚ Onset of action—Adults: within 5min; Duration—Adults: <10min
Indications
• Labeled Indications
˚ Treatment of nonhemorrhagic shock (e.g., neurogenic, renal failure, cardiac decompensation)
persisting after adequate fluid volume replacement (fluidrefractory shock)
• Off-Label Indications
˚ Symptomatic bradycardia or heart block unresponsive to atropine
Contraindications
• Hypersensitivity to sulfites
• Ventricular Fibrillation
• Pheochromocytoma
• Uncorrected tachyarrhythmias
Adverse Reactions/Precautions
• No applicable use in hemorrhagic shock unless fluid replacement therapy is maximized!
Maximize use of Blood products/Crystalloids before considering use in hemorrhagic shock.
• Doses >20mcg/kg/min likely do not have a beneficial effect on blood pressure and may increase the
risk of tachyarrhythmias. Consider other agents when doses above this range are required.
• Vesicant (causes blisters): Avoid extravasation, as it will cause tissue damage/necrosis
• Assure adequate circulatory volume to minimize the need for vasoconstrictors. Monitor BP closely,
avoid hypertension, and adjust infusion rate as needed.
• Not recommended for use in Septic Shock patients
• Pregnancy: Do not withhold in Cardiac patients.
• Lactation: Unknown
Dose/Administration
PEDIATRIC
ADULT
(Always reference Broselow Tape)
Hemodynamic Support Hemodynamic Support
• IV • IV
˚ 0.5–20mcg/kg/min; lower doses are ˚ 2–20mcg/kg/min; titrate to desired response
preferred; titrate to desired response
Bradycardia/ROSC
• IV/IO
˚ 5–20mcg/kg/min; titrate to desired response
Note: Add an additional vasopressor if
Dopamine doses of 20mcg/kg/min are inadequate
(phenylephrine, norepinephrine, epinephrine)
Note: Dopamine MOA/efficacy is dependent on
the administered dose. For:
• Renal perfusion: 1–5mcg/kg/min
• Cardiac: 5–10mcg/kg/min
• Vasoconstriction: >10mcg/kg/min

110 • MEDICATIONS