Dopamine Hydrochloride

Sympathomimetic

• - Precursor to norepinephrine, an endogenous catecholamine
• - Increases cardiac output without appreciably increasing myocardial oxygen demand
• - Stimulates alpha, beta, and dopaminergic receptors in a dose-dependent fashion

• - Cardiogenic Shock (pulmonary edema with NON-HYPOVOLEMIC hypotension) (BP<100)
• - Anaphylaxis - Refractory to Epinephrine administration and fluid boluses
• - Bradycardia - Refractory to Atropine and Transcutaneous Pacing
• - Shock states with hemodynamically significant hypotension in the ABSENCE of hypovolemia (sepsis, neurogenic shock)
• - Crush Injury

Should not be given for hemodynamically significant hypotension secondary to hypovolemia from blood loss or dehydration

• - Tachycardia, ectopic beats, nausea, vomiting, angina, palpitations, headache, and dyspnea
• - High doses can cause hypertension, requiring reduction in infusion rate

• - Anaphylaxis: infusion of 20 mcg/kg/min
• - Cardiogenic Shock (Pulmonary edema with non-hypovolemic hypotension): Infusion of 10 mcg/kg/min
• - Bradycardia: Infusion of 10 mcg/kg/min
• - Crush: Infusion of 2 mcg/kg/min

• - 400mg in 5 mL of solvent - ampules or vials
• - Also supplied as premixed solutions of 400mg in 250mL - concentration of 1600mcg/mL

• - Extravasation (infiltration) of dopamine will cause tissue necrosis and sloughing. Notify hospital staff if IV with dopamine infiltrated, as administration of phenotolamine (Regitine) to the area of infiltration is needed to treat infiltration/extravasation.
• - Monoamine oxidase inhibitors (MAOI), such as isocarboxazid (Marplan), tranylycpromine sulfate (Paranate), phenelzine sulfate (Nardil) - potemtiate effects of dopamine. Patients receiving these drugs should receive 1/10th the usual dose.
• - If infusion rate must be discontinued due to hypertension or tachyarrythmias, taper gradually rather than abruptly terminating the infusion to prevent an acute hypotensive response.