Dopamine

Question 1

Trade name

Answer 1

Inotropin

Question 2

Class

Answer 2

Adrenergic agonist
Catecholamine
Sympathomimetic

Question 3

Actions

Answer 3

Dose dependent sympathomimetic.
At 1-2 mcg/kg/min, stimulates dopaminergic receptors to produce cerebral renal and mesenteric vasodilation.
At 2-10, beta one effects predominate (mostly inotropic) with the alpha effect (vasoconstriction) beginning.
At 10-20, alpha effects predominate with renal, mesenteric, and peripheral arterial and venous vasoconstriction with a marked increase in SVR.
At 20+, alpha effects similar to norepinephrine predominate with marked peripheral vasoconstriction and tachycardia

Question 4

Indications

Answer 4

Cardiogenic shock.
Other types of shock after adequate fluid resuscitation.
Symptomatic bradycardia unresponsive to atropine or external pacemaker

Question 5

Contraindications

Answer 5

Uncorrected tachydysrhythmias.
Pheochromocytoma (can precipitate a hypertensive crisis).
Pts taking MAOIs.
Hypovolemia before fluid resuscitation

Question 6

Side effects

Answer 6

Bradycardia
Wide QRS complexes
HA
N/V
Angina
Hypotension
Can precipitate myocardial ischemia
Tissue necrosis with extravasation may occur (infiltration).

Question 7

Precautions

Answer 7

Beta blockers may decrease the effects.
Avoid extravasation which will cause tissue necrosis and tissue sloughing. Inform ER RN or MD since local injection of Regitine will be required.
Stop infusion if diastolic pressure rises above 90.
Incompatible with NaHCO3 since alkaline environment may inactivate dopamine.