Dopamine (ACLS Pharmacology)

Dopamine (ACLS Pharmacology)

So now let’s take a closer look at dopamine. Dopamine is a naturally occurring catecholamine. It has direct alpha and beta adrenergic effects
depending on the dose. Now when a medium dose is given, like 5-10
mcg per kg per minute, dopamine acts directly on beta1 receptors which causes increased
myocardial contractility and increased heart rate. When used in doses greater than 10 mcg per
kg per minute alpha receptors are stimulated, which results in an increase in systemic vascular
resistance, in other words vasoconstriction. Dopamine can be a very effective drug in treating
hypotension with signs and symptoms of shock. Dopamine is typically used as a second line
drug for symptomatic bradycardia after atropine. Now dopamine may cause tachyarrhythmias and
excessive vasoconstriction and should be used with caution in patients who are suffering
from cardiogenic shock with associated symptoms of Congestive Heart Failure. Now it’s important to correct hypovolemia
with volume replacement before we initiate dopamine therapy. The adult dosage for dopamine should be administered
via IV and it’s most common infusion rate is 2 to 20 mcg per kg per minute. We want to be sure to titrate the dosage and
drip rate to patient’s response slowly and carefully.

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