- beta receptors - increases myocardial contractility
- alpha receptors - vasoconstriction
- 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 dextrose 5%, normal saline 0.9% or Ringer's Lactate
- 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
- arrhythmias, wide QRS
- increased afterload; increased myocardial O2 consumption
- decreased peripheral perfusion
- increased blood glucose
- acute kidney injury (doses > 20 ug/kg/min)
- 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
- IV insertion site (hourly and PRN)
- continuous heart rate and ECG rhythm
- urine output
- blood pressure
- changes in skin colour
- central or mixed venous oxygen
- cardiac index if being monitored
- blood gases
- blood glucose
- 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.
|Adult Critical Care Protocol:
- May be given by IV infusion by a nurse in Adult Critical Care.
- May be titrated by a nurse in Adult Critical Care.
- Must be administered via central venous access device; in emergency situations dopamine may be temporarily infused through a peripheral vasuclar access device until a central venous line can be established.
- Patient requires placement of an arterial line to monitor BP.
- Continuous infusions must be administered by infusion device and the pump library must be enabled.
- Should not be infused via the proximal injectate port (blue) of a pulmonary artery catheter. If this is the only available central venous line, it may be administered through the proximal injectate port but thermodilution cardiac output measurements must not be measured during infusion).