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dopamine
generic
Black Box Warnings .
Extravasation
to prevent sloughing/necrosis in peripheral ischemic areas promptly use syringe with fine hypodermic needle to liberally infiltrate area with 10-15 mL saline solution containing 5-10 mg phentolamine; sympathetic blockade causes immediate conspicuous local hyperemic changes if area infiltrated within 12h
Adult Dosing .
Dosage forms: INJ
shock, adjunct tx
- [2-20 mcg/kg/min IV]
- Start: 2-5 mcg/kg/min IV, then titrate to effect in 5-10 mcg/kg/min increments; Max: 50 mcg/kg/min
heart failure, acute decompensated
- [5-15 mcg/kg/min IV]
- Info: use lowest effective dose, shortest effective tx duration
ACLS, bradycardia (off-label)
- [5-20 mcg/kg/min IV]
- Info: for patients unresponsive to atropine or if atropine use inappropriate; see ACLS: Bradycardia table
post-resuscitation stabilization (off-label)
- [5-10 mcg/kg/min IV]
- Info: refer to ACLS guidelines
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: INJ
shock, adjunct tx
- [2-20 mcg/kg/min IV]
- Start: 2-5 mcg/kg/min IV, then titrate to effect in 5-10 mcg/kg/min increments; Max: 50 mcg/kg/min
post-resuscitation stabilization (off-label)
- [2-20 mcg/kg/min IV/IO]
- Info: refer to PALS guidelines
renal dosing
- [not defined]
- renal impairment: consider adult renal dosing for guidance
- HD/PD: consider adult renal dosing for guidance
hepatic dosing
- [not defined]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- tachyarrhythmia
- ventricular fibrillation
- pheochromocytoma
- caution: hypersensitivity to sulfites
- caution: MAO inhibitor use within 14 days
- caution: hypovolemia
- caution: respiratory acidosis
- caution: vascular disease, occlusive
Drug Interactions .
Overview
dopamine
alpha/beta/dopamine agonist
- COMT substrate
- MAO substrate
- hypertensive effects
- tachycardia
Contraindicated
Avoid/Use Alternative
Monitor/Modify Tx
Caution Advised
Adverse Reactions .
Serious Reactions
- anaphylaxis
- hypotension
- ventricular arrhythmia
- atrial fibrillation
- bronchospasm
- extravasation necrosis
- gangrene
Common Reactions
- tachycardia
- headache
- nausea
- vomiting
- anxiety
- HTN
- cardiac conduction disturbance
- vasoconstriction
- angina
- palpitations
- azotemia
- dyspnea
Safety/Monitoring .
Monitoring Parameters
fluid status, acid-base balance at baseline; K; BP; ECG
Look/Sound-Alike Drug Names
DOPamine confused with: DOBUTamine; Dobutrex
Pregnancy/Lactation .
Pregnancy
Clinical Summary
benefits outweigh risks during pregnancy; risk of fetal harm not expected based on limited human data; no known risk of fetal harm based on animal data at up to 6 mg/kg/day
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no human data available, though low risk of infant harm based on drug properties; no human data available to assess effects on milk production, though possible decr. milk production based on decr. prolactin levels
Pharmacology .
Metabolism: for dopamine: liver, kidney, plasma; CYP450: unknown; Info: 25% metabolized to norepinephrine within adrenergic nerve terminals
Excretion: for dopamine: urine 80%; Half-life: 2min
Subclass: Advanced Life Support (ACLS/PALS/NALS) ; Inotropes/Pressors
Mechanism of Action
for dopamine: stimulates alpha and beta-1 adrenergic and dopaminergic receptors; produces inotropic, chronotropic, renal/splanchnic vasodilatory (at low doses), and pressor (at high doses) effects
Formulary .
No Formulary Selected
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