Classifications: alpha- and beta-adrenergic agonist; Therapeutic: cardiac stimulant; adrenergic agonist
Pregnancy Category: C
40 mg/mL, 80 mg/mL, 160 mg/mL injection
Major cardiovascular effects produced by direct action on alpha- and beta-adrenergic receptors and on specific dopaminergic
receptors in mesenteric and renal vascular beds. Positive inotropic effect on myocardium increases cardiac output with increase
in systolic and pulse pressure and little or no effect on diastolic pressure. Improves circulation to renal vascular bed
by decreasing renal vascular resistance with resulting increase in glomerular filtration rate and urinary output.
Hemodynamic effects of dopamine are dose-dependent. Due to its potential for inotropic, chronotropic, and vasopressor effects,
dopamine has several clinical uses, including decreased cardiac output as well as correction of hypotension associated with
cardiogenic and septic shock.
To correct hemodynamic imbalance in shock syndrome due to MI (cardiogenic shock), trauma, endotoxic septicemia (septic shock),
open heart surgery, and CHF.
Acute renal failure; cirrhosis; hepatorenal syndrome; barbiturate intoxication.
Pheochromocytoma; tachyarrhythmias or ventricular fibrillation; pregnancy (category C); children <2 y.
Patients with history of occlusive vascular disease (e.g., Buerger's or Raynaud's disease); CAD; cold injury; acute MI;
diabetic endarteritis, arterial embolism; neonates, lactation.
Route & Dosage
Adult: IV 25 mcg/kg/min increased gradually up to 2050 mcg/kg/min if necessary
Adolescent/Child: IV 15 mcg/kg/min increased gradually up to 20 mcg/kg/min
Adult: IV 310 mcg/kg/min
PREPARE: Continuous: ??Dilute just prior to administration. ??Dilute each ampule in one of the following: D5W, D5/NS, D5/LR, D5/0.45% NaCl, NS.??Dilute 200 mg ampule in 250 mL, 500 mL, or 1000 mL IV solution to yield 800 mcg/mL, 400 mcg/mL, or 200 mcg/mL, respectively.
Dilute 400 mg ampule in 250 mL, 500 mL, or 1000 mL IV solution to yield 1600 mcg/mL, 800 mcg/mL or 400 mcg/mL, respectively.??Dilute 800 mg ampule in 250 mL, 500 mL, or 1000 mL IV solution to yield 3200 mcg/mL, 1600 mcg/mL or 800 mcg/mL, respectively.??Consult package information for other dilutions.
ADMINISTER: Continuous: ?? Infusion rate is based on body weight.??Infusion rate and guidelines for adjusting rate relative changes in blood pressure are prescribed by physician.??Microdrip and other reliable metering device should be used for accuracy of flow rate.
INCOMPATIBILITIES Solution/additive: Acyclovir, alteplase, amphotericin B, ampicillin, metronidazole, penicillin G, sodium bicarbonate. Y-site: Acyclovir, alteplase, amphotericin b cholesteryl complex, cefepime, doxycycline, furosemide, indomethacin, insulin, lansoprazole, sodium bicarbonate, thiopental.
- Correct hypovolemia, if possible, with either whole blood or plasma before initiation of dopamine therapy.
- Monitor infusion continuously for free flow, and take care to avoid extravasation, which can result in tissue sloughing
and gangrene. Use a large vein of the antecubital fossa.
- Antidote for extravasation: Stop infusion promptly and remove needle. Immediately infiltrate the ischemic area with 510
mg phentolamine mesylate in 1015 mL of NS, using syringe and fine needle.
- Protect dopamine from light. Discolored solutions should not be used.
- Store reconstituted solution for 24 h at 2°15° C (36°59° F) or 6 h at room temperature 15°30°
Adverse Effects (≥1%)CV: Hypotension,
ectopic beats, tachycardia,
anginal pain, palpitation, vasoconstriction (indicated by disproportionate rise in diastolic pressure), cold extremities;
less frequent: aberrant conduction,
bradycardia, widening of QRS complex, elevated blood pressure. GI:
Nausea, vomiting. CNS:
Necrosis, tissue sloughing with extravasation, gangrene,
Azotemia, dyspnea, dilated pupils (high doses).
Diagnostic Test Interference
Dopamine may modify test response when histamine is used as a control for intradermal skin tests.
Interactions Drug: mao inhibitors
, ergot alkaloids
, increase alpha-adrenergic effects (headache, hyperpyrexia, hypertension); guanethidine, phenytoin
may decrease dopamine action; beta blockers
antagonize cardiac effects; alpha blockers
antagonize peripheral vasoconstriction; halothane, cyclopropane
increase risk of hypertension and ventricular arrhythmias.
<5 min. Duration:
<10 min. Distribution:
Widely distributed; does not cross bloodbrain barrier. Metabolism:
Inactive in the liver, kidney, and plasma by monoamine oxidase and COMT. Elimination:
In urine. Half-Life:
Assessment & Drug Effects
- Monitor blood pressure, pulse, peripheral pulses, and urinary output at intervals prescribed by physician. Precise measurements
are essential for accurate titration of dosage.
- Report the following indicators promptly to physician for use in decreasing or temporarily suspending dose: Reduced urine
flow rate in absence of hypotension; ascending tachycardia; dysrhythmias; disproportionate rise in diastolic pressure (marked
decrease in pulse pressure); signs of peripheral ischemia (pallor, cyanosis, mottling, coldness, complaints of tenderness,
pain, numbness, or burning sensation).
- Monitor therapeutic effectiveness. In addition to improvement in vital signs and urine flow, other indices of adequate dosage
and perfusion of vital organs include loss of pallor, increase in toe temperature, adequacy of nail bed capillary filling,
and reversal of confusion or comatose state.