Dopamine - a drug used to treat diseases of the cardiovascular system.
Release form and composition
Dopamine is released in the form of a concentrate intended for the preparation of a solution for infusion in 25, 50, 100 and 200 mg ampoules.
The composition includes 5, 10, 20 or 40 mg of dopamine hydrochloride and the following excipients:
- Water for injections;
- Sodium metabisulphite;
- 0.1 M hydrochloric acid solution
Indications for use
Dopamine is used in cases of postoperative, cardiogenic, infectious-toxic, anaphylactic and hypovolemic shock, in acute cardiovascular insufficiency, poisoning, hypotension and "low IOC" syndrome in cardiac surgical patients.
The use of Dopamine is contraindicated in cases of hypersensitivity to the active and auxiliary components that make up the product, with hypertrophic cardiomyopathy, ventricular fibrillation and pheochromocytoma.
With caution, the drug is prescribed to patients with cardiac arrhythmias, hypovolemia, myocardial infarction, metabolic acidosis, hypercapnia, hypoxia, thyrotoxicosis, children under 18 years of age, as well as in the following cases:
- Prostatic hyperplasia;
- Bronchial asthma;
- Occlusive vascular disease;
- Closed angle glaucoma.
During pregnancy and during the breastfeeding period, the use of Dopamine is permissible only in cases where the expected effect of the therapy significantly exceeds the possible risk for the developing fetus or infant.
Dosing and Administration
The solution is administered intravenously. Before applying 400-800 mg of the product diluted in 250 ml of 0.9% sodium chloride solution or 5% dextrose solution. Infusion solution must be made immediately before use.
The dosage of Dopamine is determined individually. On average, in order to obtain an inotropic effect and increase diuresis, 100-250 μg of the drug are administered to patients per minute.
When conducting intensive surgical therapy, 300-700 μg of Dopamine are used per 1 minute, and in cases of septic shock, 75-150 mg / min are used.
The maximum dose of the drug for children is 10 μg per 1 kg of body weight per 1 minute.
The instructions for Dopamine indicate that the drug may cause side effects from some body systems, namely:
- Angina pectoris, palpitations, tachycardia or bradycardia, chest pain, decrease or increase in blood pressure, expansion of the QRS complex, conduction disturbances, vasospasm and ventricular arrhythmia (cardiovascular system);
- Nausea and vomiting (digestive system);
- Headache, anxiety, tremor and motor restlessness (nervous system).
Dopamine can also cause allergic, other and local reactions, namely:
- Shock and bronchospasm (in patients with bronchial asthma);
- Dyspnea, azotemia, piloerection and polyuria;
- Necrosis of the subcutaneous tissue and skin (if it gets under the skin).
Symptoms of a dopamine overdose are tachycardia, peripheral arterial spasm, excessive increase in blood pressure, headache, dyspnea, angina pectoris, psychomotor agitation and ventricular extrasystole.
In such cases, a dose reduction or cessation of drug administration is required, with failure, the prescription of short-acting alpha-blockers and beta-blockers.
Before using Dopamine in patients who are in a state of shock, hypovolemia should be adjusted by the administration of plasma and other blood-substituting liquids. Infusion should be carried out under the control of an electrocardiogram, blood pressure, minute volume of blood circulation and diuresis. If during infusion a decrease in diuresis is observed without a concomitant decrease in blood pressure, the dose of the drug is required to be reduced.
When prescribing a drug to patients who have been receiving MAO inhibitors over the past 14-21 days, the dosage of Dopamine should not exceed 10% of the usual dose. This is due to the fact that MAO inhibitors increase the pressor effect of the drug and thus can cause vomiting, arrhythmia, headache and other manifestations of hypertensive crisis.
It is recommended to inject the solution into large veins, if possible. In case of extravasation, a necrosis of the tissues may develop, to prevent it, it is necessary to immediately infiltrate with 0.9% sodium chloride solution (10-15 ml) or phentolamine (5-10 mg).
The drug is pharmaceutically incompatible with oxidizing agents, alkaline solutions, iron salts and thiamine.
It should be borne in mind that the sympathomimetic effect of Dopamine is enhanced by MAO inhibitors, adrenostimulants, guanethidine, and diuretic effect - diuretics. The cardiotoxic effect of the drug is enhanced by inhaled drugs used for general anesthesia, tricyclic antidepressants, hydrocarbon derivatives, cocaine, and other sympathomimetics. Beta-blockers and butyrophenones weaken the cardiotoxic effect of the drug.
In turn, Dopamine weakens the hypotensive effect of methyldopa, guanadrela, guanethidine, rauwolfia alkaloids and mecamylamine.
In cases of simultaneous use of the drug with levodopa increases the risk of arrhythmias.
Dopamine and Dopmin are synonymous with the drug. Dopamine analogues include Aurocard, Korglikard, Digoxin, Celanid, Novodigal and Simdax.
Terms and conditions of storage
In accordance with the instructions, Dopamine must be stored in a well-ventilated, protected from light, dry and out of reach of children, at a temperature not exceeding 25 ºС.
From pharmacies, the drug is released on prescription. The shelf life of the concentrate, subject to the basic recommendations of the manufacturer, is three years.