Indications
Dopamine Hydrochloride is a hospital medicine given by continuous infusion into a vein to treat shock and very low blood pressure that has not improved with fluids, for example after a heart attack, in heart failure, after heart surgery, in severe infection (septic shock) or after trauma. It may also be used in some cases of very slow heart rate. It is given only by doctors and nurses in a hospital setting, usually in intensive care.
How It Works
Dopamine is a natural chemical messenger. Given into a vein, its effect depends on the dose: at moderate doses it makes the heart beat more strongly and increases the amount of blood pumped; at higher doses it also narrows blood vessels and raises blood pressure. This helps restore blood flow to vital organs such as the brain, heart and kidneys.
Dosage and Administration
Given as prescribed, by a doctor or nurse, as a carefully controlled infusion into a large vein using an infusion pump. The concentrated solution must be diluted before use. The rate is adjusted continuously according to blood pressure, heart rate, urine output and the patient’s response, with close monitoring. It is reduced gradually rather than stopped suddenly.
Interactions
MAO inhibitors (such as Selegiline) greatly increase the effect of dopamine, so much lower doses are needed. Some anaesthetic gases, tricyclic antidepressants and Phenytoin can cause heart rhythm problems or low blood pressure with dopamine. Beta blockers and alpha blockers can reduce its effect. It must not be mixed with alkaline solutions such as sodium bicarbonate.
Contraindications
Not used in people with phaeochromocytoma (an adrenal tumour that releases adrenaline-like hormones), untreated fast irregular heart rhythms such as ventricular fibrillation, or allergy to the product (some contain sulphites).
Side Effects
- Fast or irregular heartbeat, palpitations
- Chest pain, shortness of breath
- Nausea, vomiting, headache
- High or low blood pressure
- Anxiety
- Cold fingers and toes from narrowed blood vessels; at high doses this can lead to tissue damage
Leakage of the infusion into the tissue around the vein can cause severe tissue damage; tell the nurse at once about pain, burning, coldness or paleness at the drip site. The medical team will act immediately on chest pain, irregular heartbeat or very high blood pressure.
Pregnancy and Lactation
Used in pregnancy only if the benefit to the mother outweighs the possible risk; in emergencies the mother’s survival takes priority. It is not known whether it passes into breast milk; the medical team will advise.
Precautions and Warnings
Low blood volume should be corrected with fluids before or during treatment. Requires continuous monitoring of heart rhythm and blood pressure. Used with care in people with blood vessel disease, frostbite, diabetic artery disease or Raynaud’s disease, and in heart rhythm disorders.
Overdose
Overdose causes very high blood pressure and heart rhythm problems. Because dopamine acts for only a few minutes, slowing or stopping the infusion usually reverses the effect; the medical team will treat any complications.
Therapeutic Class
Inotrope and vasopressor (sympathomimetic catecholamine); hospital medicine.
Storage
Hospital use: store as directed on the pack, generally below 30°C and protected from light; do not freeze. Do not use if the solution is darker than slightly yellow or discoloured. Keep out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.