Dopamine Hcl

Drug Data Generic Name Dopamine HCl Trade Name Intropin Content Dopamine HCl Dosage 2-5 mcg/kg/min IV Availability Injection: 40, 80, 160 mg/mL Injection in 5% dextrose: 80, 160, 320 mg/100 mL

Classification Pharmacologic Class Alpha-adrenergic antagonist Beta1-selective adrenergic antagonist Therapeutic Class Dopaminergic drug Sympathomimetic Pregnancy category C

Mechanism of Action Drug acts directly and by the release of norepinephrine from sympathetic nerve terminals; dopaminergic receptors mediate dilation of vessels in the renal and splanchnic beds, which maintains renal perfusion and function; alpha receptors, which are activated by higher doses of dopamine, mediate vasoconstriction, which can override the vasodilating effects; beta1 receptors mediate a positive inotropic effect on the heart.

Indication - Correction of hemodynamic imbalances present in the shock syndrome due to MI, trauma, endotoxic septicemia, open heart surgery, renal failure, and chronic cardiac decompensation in heart failure - Poor perfusion of vital organs - Low cardiac output - Hypotension - Unlabeled Uses: COPD, heart failure, RDS in infants

Contraindications Concentrations - Pheochromocytoma - Tachyarrhytmias - Ventricular fibrillation - Hypovolemia - General anesthesia with halogenated hydrocarbons or cyclopropane, which sentisize the myocardium with catecholamines Precaution - Atherosclerosis - Arterial embolism - Raynaud's disease - Cold injury - Frostbite - Diabetic endarteritis - Buerger's disease - Pregnancy - Lactation

Adverse Reaction CNS: Headache, anxiety CV: Ectopic beats, tachycardia, anginal pain, palpitations, hypotension, vasoconstriction, dyspnea, bradycardia, hypertension, widened QRS GI: Nausea, vomiting Other: Piloerection, azotemia, gangrene with prolonged use

Nursing Responsibilities Before - Assess for contraindications. - Assess body weight, skin color, V/S, urine output, serum electrolytes, Hct, ECG. - Exercise extreme caution in calculating and preparing doses; dopamine is very potent. - Use in acute emergency situations. - Observe the 15 rights of drug administration. During - Reduce initial dosage to onetenth of usual dose in patients who have been on MAOIs. - Administer into large veins of the antecubital fossa in preference to veins in hand or ankle. - To prevent sloughing and necrosis after extravasation, infiltrate area with 10-15 mL saline containing 5-10 mg phentolamine. Do ASAP. - Monitor urine flow, cardiac output, and BP closely during infusion. After - Monitor client for at least 30 minutes. - Educate client on the side effects of the medication and what to expect. - Instruct client to report pain at injection site. - Dispose of used materials properly. - Document that drug has been given.

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, p. 406

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, p. 406

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, p. 406

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, p. 406

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, p. 406

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, p. 407

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, p. 407