Indicated for the correction of hemodynamic imbalances present in the shock syndrome due to myocardial infarction, trauma.
Dopamine is a preparation of Dopamine hydrochloride which can stimulate α, β and dopamine receptors. It is a natural catecholamine formed by the decarboxylation of 3,4-dihydroxyphenylalanine (DOPA). Dopamine is a precursor to norepinephrine in noradrenergic nerves and is also a neurotransmitter in certain areas of the central nervous system, especially in the nigrostriatal tract and in a few peripheral sympathetic nerves. It produces positive chronotropic and inotropic effects on the myocardium, resulting in increased heart rate and cardiac contractility. This is accomplished directly by exerting an agonist action on β-adrenoceptors and indirectly by causing release of norepinephrine from storage sites in sympathetic nerve endings. Dopamine does not cross the blood-brain barrier and so does not activate dopamine receptors in the brain.
Acute heart failure: Adult: As hydrochloride: Initially, 1-5 mcg/kg/min increased gradually by up to 5-10 mcg/kg/ min according to the patient’s BP, cardiac output & urine output. Up to 20-50 mcg/ kg/ min may be required in seriously ill patients.
The action of dopamine hydrochloride is potentiated by monoamine oxidase inhibitors (MAOI's). The concurrent administration of cyclopropane or halogenated hydrocarbon anesthetics may cause ventricular arrhythmias. The cardiac effects of dopamine hydrochloride are antagonized by β - adrenergic blocking agents such as Propranolol and Metoprolol. The ergot alkaloids should be avoided because of the possibility of excessive vasoconstriction. Tricyclic antidepressants and guanethidine may potentiate the pressor response to dopamine hydrochloride. Hypotension and bradycardia have been observed in patients receiving Phenytoin. Dopamine hydrochloride may increase the effect of diuretic agents. Peripheral vasoconstriction may be antagonized by α - adrenergic blocking agents, such as Phentolamine. Other vasodilators may also be useful in patients with heart failure, allowing greater inotropic and renal effects without the associated vasoconstriction. Care must be taken to avoid hypotension.
Pheochromocytoma, uncorrected tachyarrhythmias, ventricular fibrillation. Hypersensitivity. Shock secondary to Ml, history of peripheral vascular disease. Correct hypovolaemia before infusion. History of occlusive vascular disease e.g, atherosclerosis, Raynaud’s disease, Buerger’s disease, diabetic endarteritis; disproportionate increase in diastolic pressure. Pregnancy.
Nausea, vomiting, tachycardia, ectopic beats, palpitation, anginal pain, hypotension, vasoconstriction, bradycardia, hypertension, dyspnoea, headache, widened QRS complexes, azotaemia.
may use during pregnancy; risk of fetal harm not expected based on limited human data; no known risk of fetal harm based on animal data at up to 6 mg/kg/day. caution advised while breastfeeding; no human data available, though low risk of infant harm based on drug properties; no human data available to assess effects on milk production, though possible decr. milk production based on decr. prolactin levels.
In case of accidental overdosage, as evidenced by excessive blood pressure elevation, reduce the rate of administration or temporarily discontinue dopamine hydrochloride until the patients condition stabilized. Since the duration of action of dopamine hydrochloride is quite short, no additional measures are usually necessary. If these measures fail to stabilize the patient's condition, use of the short-acting α-adrenergic blocking agent such as Phentolamine should be considered.
Keep below 25°C temperature, away from light & moisture. Keep out of the reach of children.
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