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Name: Dopamine Hydrochloride

Pregnancy Category C

Drug classes

  • Sympathomimetic drug
  • Alpha-adrenergic agonist
  • Beta-1 adrenergic agonist
  • Dopaminergic agonist

Therapeutic actions

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; beta-1 receptors mediate a positive inotropic effect on the  heart.

Indications

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 congestive failure

Contraindications/cautions

Contraindicated in the presence of pheochromocytoma, tachyarrhythmias, ventricular fibrillation, hypovolemia (dopamine is not a substitute for blood, plasma, fluids, electrolytes, which should be restored promptly when loss has occurred), general anesthesia with halogenated hydrocarbons or cyclopropane, which sensitize the myocardium to catecholamines.

Use caution in the presence of atherosclerosis, arterial embolism, Reynaud's disease, cold injury, frostbite, diabetic endarteritis, Buerger's disease (closely monitor skin color and temperature of the extremities).

Adverse effects

  • GI: Nausea, vomiting
  • CV: Ectopic beats, tachycardia, anginal pain, palpitations, hypotension, vasoconstriction, dyspnea, bradycardia, hypertension, widened QRS
  • Other: Headache, piloerection, azotemia, gangrene with prolonged use

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