vasopressor

Dopamine

Intropin

Route: IV (central line preferred)
Onset: 2–5 minutes
Duration: Minutes; continuous infusion

Mechanism of action

Endogenous catecholamine precursor. Dose-dependent receptor activation: low doses (1–5 mcg/kg/min): dopaminergic D1 receptors → renal/mesenteric vasodilation. Moderate doses (5–10 mcg/kg/min): beta-1 → increased contractility and HR. High doses (>10 mcg/kg/min): alpha-1 → vasoconstriction.

Dosing

Adult: Start: 2–5 mcg/kg/min; titrate to effect. Range: 1–50 mcg/kg/min
Pediatric: Same mcg/kg/min dosing

Indications

Cardiogenic shock (inotropic support)
Septic shock (if norepinephrine unavailable — not first-line)
Symptomatic bradycardia (refractory to atropine)

Contraindications

Pheochromocytoma (catecholamine release)
Uncorrected tachyarrhythmias (ventricular fibrillation)
Hypovolemia (correct before use)

Side effects

Tachycardia / tachyarrhythmias (most common at moderate doses)
Hypertension
Nausea/vomiting
Tissue necrosis with extravasation
Increased myocardial O2 demand

Monitoring parameters

Heart rate and ECG (arrhythmia risk)
Blood pressure
Urine output
Peripheral perfusion

Drug interactions

MAOIs (severe hypertension — reduce dose by 90%)
Phenytoin (hypotension and bradycardia)
Beta-blockers (block cardiac effects)

All Drugs

Mechanism of action