Dopamine Flashcards

Study Notes

Also known as Intropin.
Classified as an adrenergic sympathomimetic, catecholamine, and inotropic agent.

Low Dose (1-5 ug/kg/min):
- Dilates renal and mesenteric arteries through dopaminergic receptor stimulation.
- May cause reduced blood pressure due to vasodilation.
Moderate Dose (5-10 ug/kg/min):
- Increases inotropy; minimal effects on chronotropy.
- Selectively stimulates beta 1 receptors, enhancing cardiac output and blood pressure.
High Dose (10-20 ug/kg/min):
- Activates alpha receptors, resulting in vasoconstriction.
- Raises blood pressure via stimulation of both alpha and beta receptors.
- Increases inotropy and chronotropy.

Cardiovascular:
- Includes tachycardia, palpitations, various blood pressure changes, chest pain, and potential ventricular irritability.
Respiratory:
- May cause dyspnea.
Gastrointestinal:
- Can lead to nausea and vomiting.

Adults:
- Administer via IVPB with concentrations of 400 mg/250cc D5W or NaCl, starting at 2-5 ug/kg/min.
- Titrate to achieve systolic BP of 90-100 and signs of adequate perfusion; do not exceed 20 ug/kg/min.
Pediatrics:
- Follow protocols or medical command for mixing concentrations. Start at 1 ug/kg/min and titrate accordingly.

Standard protocols may require dilution to 200 mg/250cc D5W or NaCl, beginning at 5 ug/kg/min.
In fluid-restricted adults, a concentration of 800 mg/250cc may be appropriate.
Potential slight beta 2 and/or alpha adrenergic effects, which are not additive to therapeutic benefits.
Avoid IVP medications through the same line as dopamine infusion to prevent interactions.
Sodium bicarbonate must never be administered in the same line as it inactivates dopamine.
Do not stop dopamine abruptly; taper off the infusion gradually to prevent rapid blood pressure drop.