Dangerous Drug: DOPamine Hydrochloride(doe’ pa meen)
PREGNANCY CATEGORY C
Drug Classes
Alpha-adrenergic agonist
Beta1-selective adrenergic agonist
Dopaminergic drug
Sympathomimetic
Therapeutic Actions
Drug acts directly and by the release of norepinephrine from sympathetic nerve terminals; dopaminergic receptors mediate dilation of vessels in the renal and splanchnic beds, which maintains renal perfusion and function; alpha receptors, which are activated by higher doses of dopamine, mediate vasoconstriction, which can override the vasodilating effects; beta1 receptors mediate a positive inotropic effect on the heart.
Indications
Correction of hemodynamic imbalances present in the shock syndrome due to MI, trauma, endotoxic septicemia, open heart surgery, renal failure, and chronic cardiac decompensation in heart failure
Poor perfusion of vital organs
Low cardiac output
Hypotension
Unlabeled uses: COPD, heart failure, RDS in infants
Contraindications and Cautions
Contraindicated with pheochromocytoma, tachyarrhythmias, ventricular fibrillation, hypovolemia (dopamine is not a substitute for blood, plasma, fluids, electrolytes, which should be restored promptly when loss has occurred), general anesthesia with halogenated hydrocarbons or cyclopropane, which sensitize the myocardium to catecholamines.
Use cautiously with atherosclerosis, arterial embolism, Raynaud disease, cold injury, frostbite, diabetic endarteritis, Buerger disease (monitor color and temperature of extremities), pregnancy, lactation.
Available Forms
Injection—40, 80, 160 mg/mL; injection in 5% dextrose—80, 160, 320 mg/100 mL
Dosages
Dilute before using; administer only by IV infusion, using an infusion pump to control the rate of flow. Titrate on the basis of patient’s hemodynamic and renal response. Close monitoring is necessary. In titrating to desired systolic BP response, optimum administration rate for renal response may be exceeded, thus necessitating a reduction in rate after hemodynamic stabilization.
Adults
Patients likely to respond to modest increments of cardiac contractility and renal perfusion: Initially, 2–5 mcg/kg/min IV.
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