Dopamine

Phaeochromocytoma, hyperthyroidism, uncorrected atrial/ventricular tachyarrhythmias or ventricular fibrillation. Concomitant use with cyclopropane and halogenated hydrocarbon anaesthetics.

Patient with CV disease, cardiac arrhythmia, history of occlusive vascular disease (e.g. atherosclerosis, Raynaud's disease, cold injury, arterial embolism, diabetic endarteritis, Buerger's disease); active myocardial ischaemia or recent MI. Patients currently taking or who have been treated with MAOIs. Avoid extravasation; if possible, infuse into a large vein to reduce the risk of tissue necrosis. Avoid abrupt discontinuation. Renal and hepatic impairment. Neonates, children, and elderly. Pregnancy and lactation. Monitoring Parameters Correct hypovolaemia, electrolyte disturbances (particularly hypokalaemia and hypomagnesaemia), hypoxia, hypercapnia, and acidosis before treatment initiation. Closely monitor blood pressure, heart rate, ECG, cardiac output, pulmonary wedge pressure, central venous pressure, end-organ perfusion (e.g. urine output, mental status), intravascular volume status, and infusion site (for extravasation or peripheral ischaemia).

Significant: Decreased pulse pressure, hypotension; necrosis and sloughing of surrounding tissues (due to extravasation). Cardiac disorders: Anginal pain, ectopic heartbeats, tachycardia, palpitation, bradycardia, cardiac conduction abnormalities. Eye disorders: Mydriasis. Gastrointestinal disorders: Nausea, vomiting. Investigations: Widened QRS complex. Nervous system disorders: Headache. Psychiatric disorders: Anxiety. Renal and urinary disorders: Azotaemia. Respiratory, thoracic and mediastinal disorders: Dyspnoea. Skin and subcutaneous tissue disorders: Piloerection. Vascular disorders: Hypertension, vasoconstriction.
Potentially Fatal: Gangrene of the extremities (particularly with high doses for prolonged periods or low doses in patients with occlusive vascular disease). Rarely, ventricular arrhythmias.

α-adrenergic receptor blockers antagonise the peripheral vasoconstriction caused by high dopamine doses. Cardiac effects of dopamine are antagonised by β-adrenergic blocking agents (e.g. metoprolol, propranolol). Potentiated effect and prolonged duration of action with MAOIs (e.g. isocarboxazid, phenelzine). May result in hypotension and bradycardia when given with phenytoin. May increase the effect of diuretics. May increase the risk of excessive vasoconstriction with ergot alkaloids. May lead to severe hypertension with some oxytocic agents. TCAs and guanethidine may potentiate the pressor response to dopamine. Haloperidol and haloperidol-like agents may suppress the dopaminergic renal and mesenteric vasodilation induced at low rates of dopamine infusion.

Cardiac Drugs

C01CA04 - dopamine ; Belongs to the class of adrenergic and dopaminergic cardiac stimulants excluding glycosides. Used in the treatment of heart failure.