- beta receptors
- increases myocardial contractility
- alpha receptors
- dopamine has not been shown to improve renal function when
administered at low doses (dopaminergic doses).
- beta dose
- 5 - 10 mcg/kg/min (titrate to desired target such as HR, blood pressure or cardiac output)
- alpha dose
- > 15
mcg/kg/min (titrate to desired target; dopamine is not the first line agent when alpha dose therapy alone is desired)
400 mg/250 mL D5W, NS, RL
- yellow or brown discolouration indicates loss of potency; discard discoloured solutions
- hypovolemia, acidosis and hypoxemia should be corrected concurrently with therapy
- should be weaned off
- increased afterload; increased myocardial O2 consumption
- decreased peripheral perfusion
- increased blood glucose
- renal failure (doses > 20 ug/kg/min)
- decreased mesenteric ischemia
- fixed, dilated pupils
- extravasation of drug will cause tissue necrosis (Rx with 5-15 mg phentolamine in NS - see phentolamine monograph)
- dopamine + IV phenytoin = decreased BP
- dopamine + inhalational anaesthetics = increased risk of ventricular arrhythmias
- dopamine + alpha blocking agents = blockade of inotropic effect
- dopamine + beta blocking agents = blockade of inotropic effect
- dopamine + other sympathomimetic agents = increased risk of toxicity
- BUN, creatinine
- ECG (widened
QRS complex, arrhythmias)
- urine output
- arterial blood
- changes in
- cardiac index
- blood glucose
- arterial lactate
- SVRI, PVRI
- NOTE: although the
use of dopamine has not been shown to improve renal function
when it is administered for the sole purpose of stimulating
dopaminergic receptors (low dose infusions), dopamine may
indirectly improve renal function if it is administered at
doses that improve cardiac ouptut.
- May be administered by IV infusion by an approved nurse in CCTC.
- May be titrated by an approved nurse in CCTC.
- Must be administered via a central line.
- Continuous infusion must be administered via an infusion pump.
- Should not be infused through the proximal injectate port (blue) of the Swan Ganz catheter.
- Patient requires placement of an arterial line to monitor BP.