Page 132 - 2023 SMOG Digital

DOPAMINE Lactation? (Use Caution) Trade Name: Intropin
Class / Mechanism of Action
Adrenergic Agonist; Vasopressor
Stimulates adrenergic and dopaminergic receptors. High doses stimulate dopaminergic and beta1
adrenergic receptors, producing cardiac stimulation and renal vasodilation. Very large doses stimulate
alpha adrenergic receptors.
Indications
Labeled Indications:
Treatment of non-hemorrhagic shock (e.g. neurogenic, renal failure, cardiac decompensation) persisting
after adequate fluid volume replacement
Unlabeled: Symptomatic bradycardia or heart block unresponsive to atropine or pacing
Contraindications
• Hypersensitivity to sulfites
• Ventricular Fibrillation
Adverse Reactions / Precautions
• No applicable use in hemorrhagic shock unless fluid replacement therapy maximized!
Maximize use of Blood products / Crystalloids before considering use in hemorrhagic shock.
• Tachycardia and/or Arrhythmias: May increase HR and worsen arrhythmias
• Vesicant: Avoid extravasation, will cause tissue damage/necrosis
• Assure adequate circulatory volume to minimize need for vasoconstrictors. Monitor BP closely, avoid
hypertension and adjust infusion rate as needed.
Dose and Administration: ADULT PEDIATRIC Always Reference BROSELOW Tape
Hemodynamic Support: Hemodynamic Support:
IV(Use microdrip chamber only): IV:
• 5-20mcg/kg/min; titrate to desired response. • "Use adult dosing"
Infusion may be increased by 1-
4mcg/kg/min at 10 to 30 minute intervals until
optimal response is obtained Note: Dopamine is a second line medication for
hemodynamic support in Pediatric patients behind
Dopamine Dosage Efficacy: Epinephrine and Norepinephrine
• 1-5mcg/kg/min=Dopaminergic effects:
increased urine output, increased renal blood
flow
• 5-10mcg/kg/min=Beta1 effects: Increased
CO, HR, and contractility
• >10mcg/kg/min=Alpha1 effects: Increased
BP, vasoconstriction
Note: Doses >20mcg/kg/minute likely do not have
a beneficial effect on blood pressure and may
increase risk of tachyarrhythmias
Add additional vasopressor if Dopamine doses of
20mcg/kg/min are inadequate. (phenylephrine,
norepinephrine, epinephrine.

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