Dopamine

• Dopamine

• Intropin

Classification:

• Sympathomimetic

Mechanism of Action:

• Stimulates both alpha and beta receptors
  • Beta: increases heart rate, contractility and stroke volume
  • Alpha: increases peripheral vasoconstriction (increases SVR)
• Different actions at different doses:
  • 1 - 3 mcg/kg/min increases renal and mesenteric perfusion
  • 3 - 10 mcg/kg/min mixed alpha and beta effects
  • 10 - 20 mcg/kg/min primarily alpha effects

Indications:

• Cardiogenic shock with BP < 70 mmHg
• Shock states with hypotension (without hypovolemia)

Contraindications:

• Untreated hypovolemia

Precautions:

•  Hypovolemia, VFib or tachycardias, Pheochromocytoma, Do not mix with NaHCO₃ 

Adverse Effects:

• Headaches
• Tremor
• Tachycardia
• Palpitation
• Angina
• Dyspnea
• Ectopic beats
• Nausea and vomiting

Dose:

Adult:

• Dose range from 2 - 20 mcg/kg/min.  Start low and titrate as quickly as necessary for response.  Some protocols mention a suggested dose range

Pediatric:

• 5 - 20 mcg/kg/min IV

• IV

• Compendium of Pharmaceuticals and Specialties (CPS)
• Pharmacology for the Prehospital Professional 2^nd Edition