Dopamine

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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.