Dopamine/d5w 1.6mg/ml Inj , 500ml
Overview
What is this medicine?
How to Use This Medicine
For storage and disposal, consult with your doctor, nurse, or pharmacist to determine the best approach if you need to keep this medication at home.
If you miss a dose, contact your doctor immediately to receive guidance on the appropriate course of action.
Lifestyle & Tips
- Not applicable as this is an acute, hospital-administered medication.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Condition-Specific Dosing:
Pediatric Dosing
Dose Adjustments
Renal Impairment:
Hepatic Impairment:
Pharmacology
Mechanism of Action
Pharmacokinetics
Absorption:
Distribution:
Elimination:
Pharmacodynamics
Safety & Warnings
Side Effects
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek medical help right away:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high blood pressure, including:
+ Severe headache or dizziness
+ Passing out
+ Changes in eyesight
Shortness of breath
Chest pain or pressure
Abnormal heartbeat (fast, slow, or irregular)
Cool or pale arm or leg
Changes in skin color to black or purple
Difficulty urinating or changes in urine output
If you notice any of the following symptoms at the injection site, inform your nurse immediately:
Redness
Burning
Pain
Swelling
Blisters
Skin sores
Leaking of fluid
This medication can cause tissue damage if it leaks from the vein.
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Upset stomach or vomiting
Headache
Anxiety
* Goosebumps
This is not an exhaustive list of possible side effects. If you have questions or concerns, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- As this medication is administered in a hospital setting with continuous monitoring, patients are not typically responsible for self-monitoring for specific warning symptoms. Any changes in condition will be monitored by healthcare staff.
Before Using This Medicine
It is essential to inform your doctor about the following conditions to ensure safe treatment:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction you experienced, including any symptoms.
If you have been diagnosed with pheochromocytoma, a type of adrenal gland tumor.
If you have a history of irregular or rapid heartbeat.
If you have low levels of potassium or magnesium in your blood.
If you have low blood volume or a condition that causes acidic blood (acidosis).
This list is not exhaustive, and it is crucial to discuss all your health problems and medications with your doctor. Provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are taking
Any natural products or vitamins you are using
Your complete medical history, including any health problems
Your doctor will assess the safety of taking this medication with your existing health conditions and medications. Do not initiate, stop, or modify the dosage of any medication without consulting your doctor first.
Precautions & Cautions
Regular blood tests will be necessary, as directed by your doctor, to monitor your condition. Be sure to discuss any concerns or questions with your doctor.
Additionally, it is crucial to check your blood pressure as instructed by your doctor.
Stopping this medication too quickly can lead to low blood pressure, which may cause severe dizziness or fainting. If you experience any of these symptoms, contact your doctor immediately.
If you have a known allergy to sulfites, consult with your doctor before taking this medication, as some products may contain sulfites.
If you are pregnant, planning to become pregnant, or are breastfeeding, it is vital to discuss the potential benefits and risks of this medication with your doctor to ensure the best possible outcome for you and your baby.
Overdose Information
Overdose Symptoms:
- Excessive increase in blood pressure (hypertension)
- Tachycardia (rapid heart rate)
- Arrhythmias (irregular heartbeats)
- Peripheral vasoconstriction (cold, pale extremities)
- Headache
- Nausea/Vomiting
What to Do:
Management involves immediate discontinuation or reduction of the infusion rate. Supportive measures, including alpha-adrenergic blocking agents (e.g., phentolamine) for severe hypertension or extravasation, may be administered. Call 1-800-222-1222 (Poison Control) for further guidance if needed in a non-clinical setting.
Drug Interactions
Contraindicated Interactions
- Monoamine Oxidase Inhibitors (MAOIs) - may cause hypertensive crisis
- Cyclopropane and halogenated hydrocarbon anesthetics - may sensitize myocardium to arrhythmias
Major Interactions
- Beta-adrenergic blocking agents (e.g., propranolol, metoprolol) - may antagonize cardiac effects of dopamine
- Alpha-adrenergic blocking agents (e.g., phentolamine) - may antagonize peripheral vasoconstriction
- Tricyclic antidepressants (TCAs) - may potentiate pressor effects
- Phenytoin - may cause hypotension and bradycardia
Moderate Interactions
- Diuretics - may have additive effects on urine output
- Oxytocic drugs - may cause severe persistent hypertension
Monitoring
Baseline Monitoring
Rationale: To establish baseline hemodynamic status and guide initial dosing.
Timing: Prior to initiation of infusion
Rationale: To assess cardiac rhythm and identify pre-existing arrhythmias.
Timing: Prior to initiation of infusion
Rationale: To assess renal perfusion and response to dopamine's renal effects.
Timing: Prior to initiation of infusion
Rationale: For comprehensive hemodynamic assessment in critically ill patients.
Timing: Prior to initiation of infusion (if invasive monitoring is in place)
Rationale: To assess tissue perfusion and severity of shock.
Timing: Prior to initiation of infusion
Routine Monitoring
Frequency: Continuously (arterial line preferred) or every 5-15 minutes
Target: Individualized, typically MAP >65 mmHg or SBP >90 mmHg
Action Threshold: Adjust infusion rate to maintain target BP; investigate hypotension/hypertension
Frequency: Continuously
Target: Individualized, avoid excessive tachycardia
Action Threshold: Adjust infusion rate if HR increases significantly or arrhythmias develop
Frequency: Continuous monitoring
Target: Normal sinus rhythm, absence of significant arrhythmias
Action Threshold: Investigate and manage new arrhythmias (e.g., ventricular ectopy, tachycardia)
Frequency: Hourly
Target: >0.5 mL/kg/hr
Action Threshold: Investigate oliguria/anuria; consider fluid status and other interventions
Frequency: Every 1-4 hours
Target: Warm, dry, good capillary refill
Action Threshold: Assess for signs of vasoconstriction or ischemia (e.g., mottling, cold extremities)
Frequency: As clinically indicated (e.g., every 1-4 hours or with dose changes)
Target: Individualized based on patient's condition and goals
Action Threshold: Adjust infusion rate or consider other interventions based on trends
Frequency: As clinically indicated (e.g., every 4-8 hours)
Target: pH 7.35-7.45
Action Threshold: Address metabolic acidosis, which can impair catecholamine effectiveness
Symptom Monitoring
- Chest pain
- Palpitations
- Dyspnea
- Headache
- Nausea/Vomiting
- Peripheral ischemia (e.g., cold, mottled extremities, pain)
- Extravasation at infusion site (swelling, pain, blanching)
Special Patient Groups
Pregnancy
Pregnancy Category C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. Use only if the potential benefit justifies the potential risk to the fetus.
Trimester-Specific Risks:
Lactation
It is not known whether dopamine is excreted in human milk. Due to the potential for serious adverse reactions in breastfed infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. Risk is generally considered low due to poor oral absorption and short half-life.
Pediatric Use
Dopamine is used in pediatric patients for similar indications as adults, with dosing based on weight (mcg/kg/min). Close monitoring of hemodynamic parameters is essential. Neonates may have reduced capacity for metabolism and excretion.
Geriatric Use
Elderly patients may be more sensitive to the effects of dopamine, particularly the pressor and chronotropic effects, and may be more prone to adverse reactions such as arrhythmias and excessive vasoconstriction. Start with lower doses and titrate slowly with careful monitoring of hemodynamic parameters and renal function.
Clinical Information
Clinical Pearls
- Dopamine exhibits dose-dependent effects: low doses for renal vasodilation, intermediate for inotropy, and high for vasoconstriction.
- Administer via a central venous catheter whenever possible due to the risk of extravasation and tissue necrosis. If extravasation occurs, infiltrate the area with phentolamine.
- Always titrate dopamine infusion to the desired hemodynamic response, not to a fixed dose.
- Correct hypovolemia prior to initiating dopamine, unless it's an emergency where immediate pressor support is needed.
- Monitor for signs of peripheral ischemia (e.g., mottling, cold extremities) especially at higher doses.
- Dopamine can increase myocardial oxygen demand, which may be detrimental in patients with coronary artery disease.
Alternative Therapies
- Norepinephrine (Levophed) - primary vasopressor for septic shock
- Epinephrine (Adrenalin) - vasopressor and inotropic agent
- Phenylephrine (Neo-Synephrine) - pure alpha-1 agonist, vasopressor
- Dobutamine (Dobutrex) - primarily inotropic agent
- Milrinone (Primacor) - phosphodiesterase inhibitor, inotropic and vasodilator