- See: -
Inotropic Agents -
Indications for Dopamine: * infuse at initial rate: 2-5 ug/kg/min, then titrate to effect, * max = 50 ug/kg/min based on effect; * at 2 - 5 ug/kg/min: dilates renal, & intestinal arterioles; * 2-10ug/kg/min (Beta > Alpha); (ideal dose range) - positive inotrop; increases
CO; * 10-20 ug/kg/min (alpha >> B): - peripheral vaso-constriction, increases BP, increased systemic resistance; - > 15 ug/kg/min may/will decrease Renal Perfussion; monitor urinary output; - dosage is too high when there is unacceptable incr. in heart rate, SVR,
PCWP pressure, orarrhythmias;
- Precautions: - dopamine increases
Wedge Pressure and requires monitoring of wedge pressure; - dopamine should be used for inotropic support and low SBP only when
Dobutamine has failed; - monitor EKG for
Tachycardia, * Supplied: Injection 40 mg/ml, 80 mg/ml, 160 mg/ml;
- Setting the Dosage: - set microdrip controller to equal the number of ug/kg/min of dopaime; - patient wt(kg) x 15 = amount of dopamine (mg) added to 250 ml of D5W; - setting of 10 microdrops then approximates 10 ug/kg/min being infused; - contents of 1 to 2 ampules (400 ug/amp) is mixed in 250 ml of 5% dextrose; - this yeilds concentration of 1600 or 3200 ug/ml, respectively; ----------------------------------------------
The renal effects of low-dose dopamine in thermally injured patients. Effects of Hypothermia on Hemodynamic Responses to Dopamine and Dobutamine.
