dopamine (dope-a-meen) Intropin, Revimine

 Indications

Adjunct to standard measures to improve: BP, Cardiac

output, Urine output in treatment of shock unresponsive to fluid replacement. Increase renal perfusion (low

doses).

Action

Small doses (0.5–3 mcg/kg/min) stimulate dopaminergic

receptors, producing renal vasodilation. Larger

doses (2–10 mcg/kg/min) stimulate dopaminergic and

beta1-adrenergic receptors, producing cardiac stimulation

and renal vasodilation. Doses greater than 10 mcg/

kg/min stimulate alpha-adrenergic receptors and may

cause renal vasoconstriction. Therapeutic Effects:

Increased cardiac output, increased BP, and improved

renal blood flow.

Pharmacokinetics

Absorption: Administered IV only, resulting in complete

bioavailability.

Distribution: Widely distributed but does not cross

the blood-brain barrier.

Metabolism and Excretion: Metabolized in liver,

kidneys, and plasma.

Half-life: 2 min.

TIME/ACTION PROFILE (hemodynamic

effects)

ROUTE ONSET PEAK DURATION

IV 1–2 min up to 10 min 10 min

Contraindications/Precautions

Contraindicated in: Tachyarrhythmias; Pheochromocytoma;

Hypersensitivity to bisulfites (some products).

Use Cautiously in: Hypovolemia; Myocardial infarction;

Occlusive vascular diseases; Geri: Older patients

may be more susceptible to adverse effects; OB:

Pregnancy and lactation (safety not established).

Adverse Reactions/Side Effects

CNS: headache. EENT: mydriasis (high dose).

Resp: dyspnea. CV: arrhythmias, hypotension, angina,

ECG change, palpitations, vasoconstriction. GI:

nausea, vomiting. Derm: piloerection. Local: irritation

at IV site.

Interactions

Drug-Drug: Use with MAO inhibitors, ergot alkaloids

(ergotamine), doxapram, or some antidepressants

results in severe hypertension. Use with IV

phenytoin may cause hypotension and bradycardia.

Use with general anesthetics may result in arrhythmias.

Beta blockers may antagonize cardiac effects.

Route/Dosage

IV (Adults): Dopaminergic (renal vasodilation) effects—

1–5 mcg/kg/min. Beta-adrenergic (cardiac

stimulation) effects—5–15 mcg/kg/min. Alpha-adrenergic

(increased peripheral vascular resistance)

effects—15 mcg/kg/min; infusion rate may be increased

as needed.

IV (Children and Infants): 1–20 mcg/kg/min, depending

on desired response (1–5 mcg/kg/min has

been used to improve renal blood flow).

IV (Neonates): 1–20 mcg/kg/min.

Availability (generic available)

Injection for dilution: 40 mg/mL, 80 mg/mL, 160

mg/mL. Premixed injection: 200 mg/250 mL, 400

mg/250 mL, 800 mg/250 mL, 800 mg/500 mL.