Dopamine

Dopamine is an adreno- and dopaminomimetic agent.

Release form and composition

Dopamine dosage form - concentrate for solution preparation for intravenous administration. In one milliliter of funds may contain 5, 10, 20 or 40 mg of dopamine (in the form of hydrochloride). Auxiliary substances used in the manufacture of the drug are sodium disulfite, hydrochloric acid, water for injection.

Available Dopamine in 5 ml ampoules.

Indications for use

After the solution is injected into the patient, Dopamine has a pronounced cardiotonic, diuretic and hypertensive effect, causing vasodilation. The clinical effect develops within 5 minutes after intravenous infusion.

According to the instructions for dopamine, indications for prescribing the drug are shock states of various nature, including cardiogenic shock, shock caused by massive blood loss, as well as hypovolemic, traumatic, anaphylactic, toxic and postoperative shock.

Since Dopamine compared with other catecholamines has less effect on peripheral vascular resistance and has less chronotropic (changing the frequency of cardiac muscle contractions) effect, its use is more justified than the use of, for example, noradrenaline. The instructions for Dopamine indicate that after the patient is injected, the blood flow in the kidneys and other internal organs, glomerular filtration, diuresis and excretion of sodium ions, the mesenteric (mesenteric) vessels expand significantly.

In addition, the use of dopamine is advisable in acute failure of the heart and vascular system, in case of arterial hypotension, as well as in cardiac surgery in the syndrome of small (low) cardiac output.

The ability of dopamine to increase diuresis can be used in patients with poisoning.

Contraindications

The use of dopamine should be avoided with pheochromocytoma, accompanied by obstruction of hypertrophic cardiomyopathy, with ventricular fibrillation, hypersensitivity to dopamine.

Patients with arrhythmia should not administer dopamine in combination with monoamine oxidase inhibitors (MAO), halogen-containing anesthetics and cyclopropane.

Special monitoring of the patient's condition during the period of treatment with Dopamine is required if it is found:

• Heart rhythm disorders (tachyarrhythmia, ventricular arrhythmias, atrial fibrillation);
• Myocardial infarction;
• Hypovolemia;
• Hypercapnia;
• Metabolic acidosis;
• Angle-closure glaucoma;
• Hypertension in the pulmonary circulation (pulmonary hypertension);
• Hypoxia;
• Thyrotoxicosis;
• Prostate hyperplasia;
• Diabetes;
• Accompanying vascular disease;
• Bronchial asthma (in particular, if a patient has a history of hypersensitivity to disulphitis).

With caution, dopamine is prescribed to patients younger than 18 years old, as well as women who are carrying a child or are breastfeeding.

Dosing and Administration

Dopamine is intended solely for intravenous administration. The dose is selected individually depending on the evidence and the patient's condition.

To obtain an inotropic effect and stimulate diuresis, dopamine is injected at a rate of 100 to 250 μg per minute (which is equivalent to 1.5-3.5 μg / min per kg of patient weight).

Intensive surgical therapy involves the introduction of 300-700 µg per minute (which corresponds to 4-10 µg / min per 1 kg of patient weight), in septic shock the dose is increased to 750-1000 µg per minute (or 10.5-21 µg / min per 1 kg of patient weight).

For a child, the optimal dose is 4-6 mcg per 1 kg of body weight, the highest dose is 10 mcg / kg / min.

In order to properly prepare the solution from dopamine concentrate, it should be diluted with 5% dextrose solution, 0.9% NaCl solution, sodium lactate solution or Ringer's lactate solution. For the preparation of a solution for intravenous infusion, 0.4-0.8 grams of dopamine is combined with 0.25 liters of solvent. This dilution allows to obtain a solution with a concentration of dopamine in 1 ml of 1.6 to 3.2 mg. Prepare it immediately before use. After preparation, it remains stable for 24 hours (except for mixtures in which Ringer's lactate solution is used as a solvent, they remain stable for no more than 6 hours).

The finished solution does not contain impurities, transparent and colorless.

Side effects

In accordance with the instructions for dopamine, the use of the drug can cause nausea, vomiting, headache. More rarely, the remedy causes angina, chest pain, rapid heartbeat, bradycardia or tachycardia, increased / decreased blood pressure, AV-conduction disturbances, vasospasm, QRS expansion, elevated left ventricular end-diastolic pressure, motor anxiety, anxiety, mydriasis, shortness of breath, pyeloedema, increased left ventricular end-diastolic pressure, anxiety, anxiety, mydriasis, shortness of breath, pyloedema, increased left ventricular end-diastolic pressure, anxiety, anxiety, mydriasis, shortness of breath, pyeloedema, increased left ventricular end-diastolic pressure, motor anxiety, anxiety, mydriasis, shortness of breath, pyeloedema, diastolic pressure, motor anxiety, anxiety, mydriasis, short breath azotemia.

High doses of dopamine can cause supraventricular (supraventricular) or ventricular arrhythmias. In patients with asthma, shock and bronchospasm are possible.

After administration of dopamine in low doses, polyuria can be observed in rare cases.

If the solution gets under the skin, it can lead to necrosis of the subcutaneous tissue and skin.

special instructions

The drug is administered under the control of ECG, blood pressure, heart rate, diuresis and minute blood volume.

Dopamine is characterized by pharmaceutical incompatibility with alkaline solutions, iron salts, oxidizing agents, thiamine.

Analogs

Dopamine Solvay 50, Dopamine Solvay 200, Dopmin, Dopamine-Darnitsa, Dopamine, Dopamine Amed.

Terms and conditions of storage

It is recommended to keep the concentrate in the reach of children, protected from light, where the temperature is maintained from 8 to 25 ºC. Its shelf life is 3 years.

From pharmacies Dopamine prescription.