Description
Dopamine-Ferein Pharmacodynamics
Cardiotonic and hypertensive agent. Dopamine receptor agonist, is their endogenous ligand.
At low doses (0.5-3 µg/kg/min) it acts mainly on dopamine receptors, causing dilation of renal, mesenteric, coronary and cerebral vessels. Due to its specific effect on peripheral dopamine receptors, it reduces renal vascular resistance and increases renal blood flow, glomerular filtration, sodium ion excretion and diuresis, and dilation of mesenteric vessels (this distinguishes dopamine effect on renal and mesenteric vessels from other catecholamines).
In low and medium doses (2-10 µg/kg/min), it stimulates postsynaptic beta1-adrenoreceptors, which causes a positive inotropic effect and an increase in the minute blood volume. Systolic BP and pulse pressure may increase; diastolic BP is unchanged or slightly increased. OPSS usually does not change. Coronary blood flow and myocardial oxygen consumption are usually increased.
At high doses (10 µg/kg/min or more), stimulation of ?1-adrenoreceptors predominates, causing increased ROS, HR and renal vasoconstriction (the latter may reduce previously increased renal blood flow and diuresis). Due to the increase in the minute blood volume and OPPS, both systolic and diastolic BP increase.
The onset of therapeutic effect is within 5 min against the background of IV administration and lasts for 10 min.
Indications
Shock of different genesis (cardiogenic, postoperative, infectious-toxic, anaphylactic, hypovolemic /only after CCB recovery/). Acute cardiovascular insufficiency of various genesis, low cardiac output syndrome in cardiac surgery patients, arterial hypotension, to enhance diuresis during poisoning.
Contraindications
Hypertrophic obstructive cardiomyopathy, pheochromocytoma, ventricular fibrillation, hypersensitivity to dopamine.
Dosage and administration
- It is set individually depending on the severity of shock, BP value and patient’s response to dopamine administration. In order to increase myocardial contractility and increase diuresis, dopamine is administered by IV drip 100-250 mcg/min. If it is necessary to influence BP, the dose is increased to 300-500-700 mcg/min.
- Children are administered in a dose of 4-6 µg/kg/min.
- The duration of dopamine administration may be up to 28 days.
- The maximum dose for adults when administered by IV drip is 1.5 mg/min.
