Names and pronunciation
(dope′a-meen)
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Drug reference
(dope′a-meen)
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Func. class.: Adrenergic
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Chem. class.: Catecholamine
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Do not confuse: DOPamine/DOBUTamine
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ACTION: Causes increased cardiac output; acts on β1- and α-receptors, causing vasoconstriction in blood vessels; low dose causes renal and mes- enteric vasodilation; β1 stimulation pro- duces inotropic effects with increased cardiac output
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USES: Shock, increased perfusion, hypo tension, cardiogenic/septic shock
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CONTRAINDICATIONS: Hyper- sensitivity, ventricular fibrillation, tachy- dysrhythmias, pheochromocytoma, hypo- volemia Precautions: Pregnancy, breastfeeding, geriatric patients, arterial embolism, peripheral vascular disease, sulfite hyper- sensitivity, acute MI
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Black Box Warning: Extravasation Black Box Warning: Extravasation: if extravasation occurs, stop infusion; may inject area with phentolamine 10 mg/15 mL of NS Y-site compatibilities: Alfentanil, alprostadil, amifostine, amikacin, aminocaproic acid, aminophylline, amiodarone, anidulafungin, argatroban, ascorbic acid injection, ateno- lol, atracurium, atropine, aztreonam, benz- tropine, bivalirudin, bleomycin, bumetanide, buprenorphine, butorphanol, calcium chlo- ride/gluconate, CARBOplatin, caspofungin, cefmetazole, cefonicid, cefotaxime, cefo- TEtan, cefOXitin, cefTAZidime, ceftizoxime, cefTRIAXone, cefuroxime, chlorproMAZINE, cimetidine, ciprofloxacin, cisatracurium, CISplatin, cladribine, clarithromycin, clindamycin, cloNIDine, codeine, cyanoco- balamin, cyclophosphamide, cycloSPORINE, cytarabine, DACTINomycin, DAPTOmycin, dexamethasone, dexmedetomidine, digoxin, diltiazem, diphenhydrAMINE, DOBUTamine, DOCEtaxel, doripenem, doxacurium, DOXOrubicin, DOXOrubicin liposomal, doxycycline, droperidol, enalaprilat, ePHEDrine, EPINEPHrine, epirubicin, epoe- tin alfa, eptifibatide, ertapenem, erythromy- cin, esmolol, etoposide, famotidine, fenoldopam, fentaNYL, fluconazole, fludara- bine, fluorouracil, folic acid, foscarnet, gati- floxacin, gemcitabine, gemtuzumab, genta- micin, glycopyrrolate, granisetron, heparin, hydrocortisone, HYDROmorphone, hydrOXYzine, IDArubicin, ifosfamide, imipe- nem-cilastatin, irinotecan, isoproterenol, ketorolac, labetalol, levofloxacin, lidocaine, linezolid, LORazepam, LR, magnesium sul- fate, mannitol, mechlorethamine, meperi- dine, methicillin, methyldopate, methyl- PREDNISolone, metoclopramide, metoprolol, metroNIDAZOLE, micafungin, miconazole, midazolam, milrinone, minocy- cline, mitoXANtrone, morphine, multiple vitamins injection, mycophenolate, nafcillin, nalbuphine, naloxone, netilmicin, niCARdi pine, nitroglycerin, nitroprusside, norepi- nephrine, octreotide, ondansetron, oxacil- lin, oxaliplatin, oxytocin, PACLitaxel, palonosetron, pamidronate, pancuronium, pantoprazole, papaverine, PEMEtrexed, penicillin G potassium/sodium, pentami- dine, pentazocine, PENTobarbital, PHENo- barbital, phenylephrine, phytonadione, piperacillin, piperacillin-tazobactam, poly myxin B, potassium chloride, procainamide, prochlorperazine, promethazine, propofol, propranolol, protamine, pyridoxine, quiNI- D Dine, ranitidine, remifentanil, Ringer’s, rito- drine, riTUXimab, rocuronium, sargramos- tim, sodium acetate, succinylcholine, SUFentanil, tacrolimus, temocillin, tenipo- side, theophylline, thiamine, thiotepa, ticar- cillin, ticarcillin-clavulanate, tigecycline, tirofiban, TNA, tobramycin, tolazoline, TPN, trastuzumab, trimetaphan, urokinase, vancomycin, vasopressin, vecuronium, verap amil, vinCRIStine, vinorelbine, vitamin B complex/C, voriconazole, warfarin, zidovu- dine, zoledronic acid
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SIDE EFFECTS CNS: Headache, anxiety CV: Palpitations, angina, wide QRS complex, peripheral vasoconstriction, hypotension GI: Nausea, vomiting, diarrhea INTEG: Necrosis, tissue sloughing with extravasation RESP: Dyspnea
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INTERACTIONS • Do not use within 2 wk of MAOIs; hyper- tensive crisis may result Increase: bradycardia, hypotension— phenytoin Increase: dysrhythmias—general anes- thetics Increase: severe hypertension—ergots Increase: B/P—oxytocics Increase: pressor effect—tricyclics, MAOIs Decrease: DOPamine action—beta-/ alpha-blockers Drug/Lab Test Increase: urinary catecholamine, serum glucose
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TREATMENT OF OVERDOSE: Discontinue IV, may give a short-acting alpha-adrenergic blocker
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DOSAGE AND ROUTES • Adult: IV INFUSION 2-5 mcg/kg/min, titrate upward in 5-10 mcg/kg/min incre- ments, max 50 mcg/kg/min; titrate to patient’s response • Child: IV 1-5 mcg/kg/min initially; usual dosage range, 2-20 mcg/kg/min HF • Adult: IV 3-10 mcg/kg/min Bradycardia (unlabeled) • Adult: IV 2-10 mcg/kg/min, titrate as needed
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Available forms: Injection 40 mg, 80 mg, 160 mg/mL; concentrations for IV infusion 0.8, 1.6, 3.2 mg/mL in 250, 500 mL D5W
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Administer: • Correct volume depletion prior to use • Store reconstituted solution for up to 24 hr if refrigerated • Do not use discolored solution; pro- tect from light IV route • IV after diluting 200-400 mg/250-500 mL of D5W, D50.45%NaCl, D50.9%NaCl, D5LR, LR; use large vein • After reconstituting, use infusion pump; give at rate of 0.5-5 mcg/kg/min, increase by 1-4 mcg/kg/min at 10-30 min intervals until desired response, titrate as needed, decrease infusion gradually
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Assess: • Hypovolemia; if present, correct first • Oxygenation/perfusion deficit: check B/P, chest pain, dizziness, loss of consciousness • Heart failure: S3 gallop, dyspnea, neck venous distention, bibasilar crackles in patients with HF, cardiomyopathy, pal- pate peripheral pulses • I&O ratio: if urine output decreases without decrease in B/P, product may need to be reduced • ECG during administration continu- ously; if B/P increases, product should be decreased; PCWP, CVP during infusion • B/P, pulse q5min • Paresthesias and coldness of extremi- ties; peripheral blood flow may decrease • Pregnancy/breastfeeding: no well- controlled studies; use only if benefit out- weighs fetal risk, may cause toxicity; avoid use in breastfeeding, excretion is unknown
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Evaluate: • Therapeutic response: increased B/P with stabilization; increased urine out- put
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • About the reason for product adminis- tration • To report immediately chest pain, shortness of breath, numbness/tingling of extremities • To report immediately pain, burning, redness at IV site
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PHARMACOKINETICS IV: Onset 5 min; duration <10 min; metab- olized in liver, kidney, plasma; excreted in urine (metabolites); half-life 2 min
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• Adult: IV INFUSION 2-5 mcg/kg/min, titrate upward in 5-10 mcg/kg/min incre- ments, max 50 mcg/kg/min; titrate to patient’s response
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• Adult: IV 3-10 mcg/kg/min Bradycardia (unlabeled)
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• Adult: IV 2-10 mcg/kg/min, titrate as needed
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