Dopamine

Question 0

Drug classification

Answer 0

Sympathomimetic agent (catecholamine)

Question 1

Trade name

Answer 1

Intropin

Question 2

Actions – low dose (2)

Answer 2

1. Dilated renal and mesenteric arteries by stimulating dopaminergic receptors
2. May decrease blood pressure due to vasodilation

Question 3

Low dose dosage

Answer 3

1-4 mcgm/kg/min

Question 4

Actions – moderate dose (2)

Answer 4

1. Increases inotropy without increasing chronotropy

2. Increases blood pressure by stimulating beta-1 receptors

Question 5

Moderate dose dosage

Answer 5

5-10 mcgm/kg/min

Question 6

Actions - high dose (3)

Answer 6

1. Causes vasoconstriction by stimulating alpha receptors
2. Increases inotropy and chronotropy by stimulating beta-1 receptors
3. Increases blood pressure by stimulating alpha and beta-1 receptors

Question 7

High dose dosage

Answer 7

> 10-20 mcgm/kg/min

Question 8

Contraindication (2)

Answer 8

1. Hypovolemia

2. Tachydysrhythmias

Question 9

Adverse effects - cardiovascular (6)

Answer 9

Tachycardia
Hypertension
Hypotension
Chest pain 
Ventricular irritability
Vasoconstriction

Question 10

Adverse effect - respiratory

Answer 10

Dyspnea

Question 11

Adverse effect - gastrointestinal

Answer 11

Nausea/vomiting

Question 12

Administration

Answer 12

Add 400mg to 500mL of NS as an IVPB

Start at 30 mcgtts/minute. Titrate to BP of 90-100 systolic and signs of adequate perfusion or to a maximum of 120 mcgtts/min

Question 13

Pediatrics

Answer 13

Add 6 mg/kg to 100mL NS as an IVPB

Start at 10 mcgtts/minutes. Titrate to a sign of adequate perfusion or to a maximum of 20 mcgtts/minute

Question 14

Onset

Answer 14

5 minutes

Question 15

Duration

Answer 15

5-10 minutes

Question 16

Precaution

Place patient on ECG monitor

Answer 16

Rationale

Causes ventricular irritability

Question 17

Precaution

Aspirated prior to administration to ensure IV patency. Start in largest possible vein.

Answer 17

Rationale

Causes tissue necrosis if injected into interstitial space.

Question 18

Precaution

Flush IV tubing before and after administration of sodium bicarbonate or start a Second IV line

Answer 18

Rationale

Inactivated by sodium bicarbonate

Question 19

Precaution

Establish a second IV for venous access for additional drug administration.

Answer 19

Rationale

Dopamine infusion should not be interrupted to ensure adequate therapeutic blood levels.

Question 20

Precaution

Take vital signs every 5 minutes

Answer 20

Rationale

Titrate dosage based on vital signs.

Question 21

Note

Answer 21

Flow rate determines which receptor sites are stimulated and result in a graded response. The following doses are calculated for an 80 kg patient using a concentration of 400mg/500mL NS

Question 22

Low dose - drops/minute

Answer 22

6-24 mcgtts/min

Question 23

Moderate dose - drops/minute

Answer 23

30-60 mcgtts/min

Question 24

High dose- drops/minute

Answer 24

Over 60 mcgtts/minute

Question 25

Low dose - receptor(s) affected

Answer 25

Dopaminergic

Question 26

Moderate dose - receptor(s) affected

Answer 26

Dopaminergic and beta

Question 27

High dose - receptor(s) affected

Answer 27

Dopaminergic Beta Alpha

Question 28

In moderate dose....

Answer 28

Alpha receptors begin to be stimulated and peripheral vasoconstriction occurs.

Question 29

High dose...

Answer 29

...alpha receptors override dopaminergic receptors resulting in decreased renal and mesenteric perfusion

Question 30

How supplied

Answer 30

40mg/mL 80mg/mL 160 mg/mL Vials - OR 800mcg/mL 1,600 mcg/mL 3,200 mcg/mL in 250 mL or 500mL bags of D50W