Dopamine

General

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

Adult Dosing

Dosing

• Low dose:
  • 1-5 mcg/kg/min - Vasodilation (renal, mesenteric, coronary)
  • 5-10 mcg/kg/min - predominant β₁
• High dose: 10-20 mcg/kg/min - predominant α₁
• Titrate to clinical effect
  • Use lowest dose possible (prevent tachyphylaxis)
• May use in peripheral IV temporarily
  • Avoid using in same line as alkaline infusions

Rate of Titration

• Q2-5 min

Special Populations

• Pregnancy Rating: Class C
• Lactation:
• Renal Dosing
  • Adult
  • Pediatric
• Hepatic Dosing
  • Adult
  • Pediatric

Contraindications

• Allergy to class/drug
• Tachyarrhythmias

Adverse Reactions

• Low doses:
  • Hypotension
• High doses:
  • Hypertension, ectopic beats
• Tissue necrosis (if extravasates)
  • If occurs use phentolamine 5-10mg in affected area

Pharmacology

• 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

Notes

Indications

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