Description and indication for use
Dopamine is a naturally occurring
catecholamine with sympathomimetic actions.
Dopamine acts on both alpha and beta adrenergic receptors as well as
peripheral dopamine receptors causing both isotropic and chronotropic
responses.
The isotropic action strengthens the muscle
contractibility of the heart and chronotropic action increases heart rate. The major action of Dopamine is that it
causes vasodilatation of renal, coronary, mesenteric and intracerebral beds
with little effect on blood pressure or heart rate at low doses.
Dopamine is used to improve cardiac output,
blood pressure and urine output in critically ill patients with hypotension.
Dose
Improvement of cardiac output and BP
IV infusion:
2 to 20 mcg/kg/minute.
Improvement of renal perfusion
IV infusion:
2 to 5 mcg/kg/minute.
Reconstitution
Ampoule = 200 mg in 5 mL.
IV:
Withdraw required dose and make up to
ordered volume of fluid for infusion via pump.
Usual order will be as follows:
|
Drug
|
How
to make up
|
Dose
equivalent
|
Dose
range
|
|
Dopamine
|
60 mg/kg in 50 mL glucose 10%
|
1 mL/hr = 20 micrograms/kg/min
|
4 - 20 micrograms/kg/min
|
Not for IM use.
Route and method of administration
IV Infusion:
Continuous infusion via syringe pump.
Administer only into a central line.
Side effects
Hypotension/Hypertension.
Reduced or excessive diuresis.
Tachycardia.
GI tract upset.
Ectopic beats.
Vasoconstriction.
Metabolic acidosis.
Tissue sloughing and necrosis may occur if
extravasation of Dopamine occurs at infusion site, due to local vasoconstriction.
Compatibilities
Fluids:
Glucose 5%, Glucose 10%, Sodium chloride
0.9%.
Drugs:
Aminophylline, Dobutamine, Glyceryl Trinitrate, Heparin, Hydrocortisone, Potassium Chloride, Ranitidine, Verapamil.
Via Y-site:
Amiodarone, Ciprofloxacin, Dobutamine, Glyceryl Trinitrate, Heparin, Hydrocortisone, Morphine, Potassium Chloride, Ranitidine, Verapamil.
Incompatibilities
Fluids: Sodium Bicarbonate and
other alkaline solutions.
Drugs: Aciclovir, Ampicillin, Gentamicin, Amphotericin B, Frusemide, Indomethacin, Insulin.
Administer alone or contact Pharmacy for
further information if required.
Special precautions
Hypovolaemic states should be corrected prior
to Dopamine administration.
Do not bolus other drugs via Dopamine
infusion line.
Never stop a Dopamine infusion abruptly.
Contraindications
Uncorrected tachyarrhythmias.
Drug interactions
|
Phenytoin
|
Administered to patients receiving dopamine may
result in severe hypotension and hypovolaemic shock states. Use
with extreme caution.
|
Nursing responsibilities
Continuous blood pressure monitoring preferably
with an arterial line.
Continuously monitor heart rate and rhythm.
Record vital signs hourly.
Observe and measure urine output.
Observe intravenous site for inflammation
and extravasation - resite infusion immediately.
DO NOT GIVE BOLUS DOSES .
Avoid interruption.
USE SYRINGE PUMP.
Change infusion fluid every 24 hours and
line every 3 days (as per RCH IV Line Protocol). When changing syringe and line, ensure 3-way
tap is turned off to avoid giving bolus.
Check that rate ordered corresponds with
dose required (micrograms/kg/min).