Dopamine Hydrochlorid

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junglejim
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94842
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Dopamine Hydrochlorid
Updated:
2011-07-22 10:50:49
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Dopamine Hydrochlorid paramedic
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Dopamine Hydrochlorid study cards
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  1. Dopamine Class:
    • Adrenergic Dopaminergic Catecholamine
    • Sympathomimetic
  2. Dopamine Mechanism of Action:
    • Naturally occurring catecholamine that is the chemical precursor of norepinephrine. Is generally dose dependant on its effects.
    • 1-2 μg/kg/min--dopaminergic receptors--dilation of renal, mesenteric, and cerebral arteries
    • 2-10 μg/kg/min--beta receptors--inotropic, chronotropic
    • 10-20 μg/kg/min--alpha & beta--vasoconstriction of renal, mesenteric, and peripheral arteries and veins
    • >20 μg/kg/min--Mimics pure alpha effects similar, to norepinepherine like effects. It is occasionally used at this range in-hospital.
  3. Dopamine Indications:
    • Cardiogenic Shock
    • Cardiogenic Shock w/ Pulmonary Edema (CHF)
    • Hypovolemic Shock / Hypotension (after fluid resuscitation)
    • Neurogenic Shock
    • Septic Shock
  4. Dopamine Contraindications:
    • Women on oxytocin
    • Tachydysrhythmias
    • VF/VT
    • Uncorrected hypovolemia
    • Patients with known pheochromocytoma
  5. Dopamine Precautions:
    • MAOIs,TCAs, other cardiac stimulants, vasopressors, will cause increased heart rate, and SV dysrhythmias
    • Will precipitate in basic, alkaline solutions
    • May cause necrosis, sloughing at infusion site
    • Pregnancy (C)
  6. Dopamine Dosage Adults:
    • 2-20 μg/kg/min, occasionally up to 50 μg/kg/min, generally not exceeding 20 μg/kg/min without medical control guidance.
    • Titrated to effect, run through a large vein.
    • Generally add two vials 200 mg to 250 ml NS, yielding 1600 μg/ml, although some alternative methods exist
  7. Dopamine Dosage Pediatrics:
    • 2-20 μg/kg/min, with 10 μg/kg/min is a reasonable starting dose, titrated to effect, generally not exceeding 20 μg/kg/min.
    • Add 6 mg x weight in kg diluted to 100 ml, to create drip.
    • 1gtt/min (cc/hr) equals 1 μg/kg/min.
  8. Dopamine Onset:
    2-4 min.
  9. Dopamine Duration:
    10-15 min
  10. Dopamine Side Effects:
    • Dysrhythmias
    • HTN
    • Headache
    • Nausea & Vomiting
    • Dizziness
    • Tremors
    • Flushing
    • Angina, AMI
    • Pain
    • Ectopy
    • Bradycardia
    • Tachycardia, Including ventricular fibrillation, ventricular tachycardia
  11. Dopamine Interactions:
    • Potentiating effects--TCAs, MAOIs, bretylium
    • Precipitates in Alkaline Solutions
    • Dopamine may cause hypotension when used concomitantly with phenytoin (Dilantin)
  12. Dopamine PEARLS: ƒ
    • Can cause tissue necrosis and sloughing. Take care to avoid infiltration, use central intravenous access or the large veins of the arm ƒ
    • Titrate dosage to patient’s hemodynamic response
  13. Dopamine Infusion Matrix

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