Dopamine: Difference between revisions

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==General==
==General==
*Type: [[Vasopressors]]
*Type: [[Is DrugClass::Vasopressors]]
*Dosage Forms:
*Dosage Forms: IV
*Common Trade Names:  
*Common Trade Names: Intropin
 
==Indications==
*[[Hypotension]] caused by:
**Septic shock
**Bradycardia
**MI
**Trauma/spinal shock
**Heart failure


==Adult Dosing==
==Adult Dosing==
===Dosing===
*Shock (adjunct):
*Low dose:  
**1-50 mcg/kg/min IV
**1-5 mcg/kg/min - Vasodilation (renal, mesenteric, coronary)
***Max 20-50 mcg/kg/min
**5-10 mcg/kg/min - predominant β1
***Increase 1-4 mcg/kg/min q10-30 min, titrate to effect
*High dose: 10-20 mcg/kg/min - predominant α1
*Refractory Heart Failure:
*Titrate to clinical effect
**1-3 mcg/kg/min IV
**Use lowest dose possible (prevent tachyphylaxis)
*[[Bradycardia]] (in patients unresponsive to atropine):
*May use in peripheral IV temporarily
**2-10 mcg/kg/min IV
**Avoid using in same line as alkaline infusions
*Post-resuscitation stabilization:
===Rate of Titration===
**5-10 mcg/kg/min IV
*Q2-5 min


==Pediatric Dosing==
==Pediatric Dosing==
*Shock (adjunct):
**5-10 mcg/kg/min IV (max dose of 20 mcg/kg/min)
***Increase 1-4 mcg/kg/min q10-30 min, titrate to effect
*Post-resuscitation stabilization:
**2-20 mcg/kg/min IV/IO


==Special Populations==
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]:
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: Class C
*Lactation:
*Lactation: Use caution (limited data)
*Renal Dosing
*Renal Dosing
**Adult
**Adult: no adjustment
**Pediatric
**Pediatric: no adjustment
*Hepatic Dosing
*Hepatic Dosing
**Adult
**Adult: N/A
**Pediatric
**Pediatric: N/A


==Contraindications==
==Contraindications==
*Allergy to class/drug
*Allergy to class/drug
*Tachyarrhythmias
*Tachyarrhythmias
*Pheochromocytoma


==Adverse Reactions==
==Adverse Reactions==
*Low doses:
**Hypotension
*High doses:
**Hypertension, ectopic beats
*Tissue necrosis (if extravasates)
**If occurs use phentolamine 5-10mg in affected area
===Serious===
===Serious===
*[[Anaphylaxis]]
*[[Hypotension]]
*Ventricular arrhythmias
*Bronchospasm
*[[Atrial fibrillation]]
*Extravasation necrosis
*Gangrene


===Common===
===Common===
*[[Tachycardia]]
*[[Headache]]
*Nausea/vomiting
*Anxiety
*[[Hypertension]]
*[[Angina]]
*[[Palpitations]]
*[[Dyspnea]]
*Azotemia


==Pharmacology==
==Pharmacology<ref>Dopamine: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019. </ref>==
*Half-life:  
*Half-life:  
** 2 minutes
*Metabolism:  
*Metabolism:  
** Renal, Hepatic, Plasma
*Excretion:  
*Excretion:  
** Urine as metabolites
*Mechanism of Action:
*Mechanism of Action:
===Primary Receptor===
===Primary Receptor===
* Low dose: DA, β1
*Low dose: DA, β<sub>1</sub>
* High dose: DA, α1 >> β1
*High dose: DA, α<sub>1</sub> >> β<sub>1</sub>  
===Relative Effects===
===Relative Effects===
*Low dose: Natriuresis, ↑↑HR, ↑↑SV
*Low dose: Natriuresis, ↑↑HR, ↑↑SV
*High dose: ↑SVR and ↑SV
*High dose: ↑SVR and ↑SV
==Notes==
===Indications===
*Hypotension caused by:
**Septic shock
**MI
**Trauma/spinal shock
**Heart failure


==See Also==
==See Also==
*[[Vasopressors]]
*[[Dobutamine]]
*[[Cardiogenic shock]]
*[[Shock]]


==Sources==
==References==
<references/>


<references/>
[[Category:Pharmacology]]
[[Category:Drugs]]
[[Category:Critical Care]]

Latest revision as of 20:30, 19 July 2025

General

  • Type: Vasopressors
  • Dosage Forms: IV
  • Common Trade Names: Intropin

Indications

  • Hypotension caused by:
    • Septic shock
    • Bradycardia
    • MI
    • Trauma/spinal shock
    • Heart failure

Adult Dosing

  • Shock (adjunct):
    • 1-50 mcg/kg/min IV
      • Max 20-50 mcg/kg/min
      • Increase 1-4 mcg/kg/min q10-30 min, titrate to effect
  • Refractory Heart Failure:
    • 1-3 mcg/kg/min IV
  • Bradycardia (in patients unresponsive to atropine):
    • 2-10 mcg/kg/min IV
  • Post-resuscitation stabilization:
    • 5-10 mcg/kg/min IV

Pediatric Dosing

  • Shock (adjunct):
    • 5-10 mcg/kg/min IV (max dose of 20 mcg/kg/min)
      • Increase 1-4 mcg/kg/min q10-30 min, titrate to effect
  • Post-resuscitation stabilization:
    • 2-20 mcg/kg/min IV/IO

Special Populations

  • Pregnancy Rating: Class C
  • Lactation: Use caution (limited data)
  • Renal Dosing
    • Adult: no adjustment
    • Pediatric: no adjustment
  • Hepatic Dosing
    • Adult: N/A
    • Pediatric: N/A

Contraindications

  • Allergy to class/drug
  • Tachyarrhythmias
  • Pheochromocytoma

Adverse Reactions

Serious

Common

Pharmacology[1]

  • Half-life:
    • 2 minutes
  • Metabolism:
    • Renal, Hepatic, Plasma
  • Excretion:
    • Urine as metabolites
  • Mechanism of Action:

Primary Receptor

  • Low dose: DA, β1
  • High dose: DA, α1 >> β1

Relative Effects

  • Low dose: Natriuresis, ↑↑HR, ↑↑SV
  • High dose: ↑SVR and ↑SV

See Also

References

  1. ↑ Dopamine: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.
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