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What is Dopamine? A quick guide to Dopamine- AHA Guidelines


Dopamine has been used in critical care for many years and is frequently administered in Intensive Care departments, Emergency departments and used in some Emergency Medical Services systems around the world for critically-ill patients. It has a role in our ACLS management of Bradycardia and plays a role in the management of shock.


Mechanism of Action:

  • Endogenous catecholamine; Potent α and β adrenergic stimulating properties; Increased Chronotropy;

  • Increased Inotropy

  • The effects is dose-dependent

Indications:

  • Second-line drug for Symptomatic Bradycardia after Atropine or where TCP is ineffective.

  • Hypotension and the management of shock unresponsive to fluid administration.

  • Post resuscitation care guidelines as per the American Heart Association.

Dose:

  • The AHA recommended infusion rate: 5-20 mcg/kg per minute.

  • Titrate dose against the effect required and ensure to taper slowly.

Important:

  • Correct hypovolemia with volume replacement before initiating dopamine.

  • Also, Do not mix Dopamine with sodium bicarbonate

  • We should use it with caution in patients with cardiogenic shock with accompanying congestive heart failure

Side Effects:

  • Some of the side effects and not limited to includes Tachyarrhythmia’s, and at higher doses, it may cause Ventricular Tachycardia,

  • Palpitations, Nausea & Vomiting

  • Headache, Anxiety

  • Asthmatic episodes

  • And Extravasation may result in tissue Necrosis

In recent years Dopamine has fallen out of favor due to a host of adverse effects with no additional benefits when compared to Nor-Epinephrine and Epinephrine.


Dopamine is still part of the American Heart Association’s 2020 Guidelines.

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