| Name: |
DOPAMINE (IntropinR) |
| Classification: |
sympathomimetic
- beta receptors
- increases myocardial contractility
- alpha receptors
- vasoconstriction
- dopamine has not been shown to improve renal function when
administered at low doses (dopaminergic doses).
|
| Dose: |
|
| Administration: |
IV Infusion
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
|
| Adverse Effects: |
- tachycardia
- increased afterload; increased myocardial O2 consumption
- arrhythmias
- 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)
|
| Drug Interactions: |
- 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
|
| Monitoring Therapy: |
- HR
- BUN, creatinine
- ECG (widened
QRS complex, arrhythmias)
- urine output
- arterial blood
pressure
- changes in
skin colour
- cardiac index
- blood glucose
- arterial lactate
- SVRI, PVRI
- electrolytes
- PWP
- 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.
|
| CCTC Protocol: |
- 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.
|