Dopamine looks like a white crystalline powder with a faint odor of hydrochloric acid. It looks like this in the form of hydrochloride. "Dopamine" is a substance that is soluble in water and alcohol. It is affected by alkalis, various oxidizing agents and iron s alts. Indications and contraindications for the use of the drug "Dopamine", instructions for its use are available in our publication.
The product is available as a concentrate for infusion solution.
Pharmacological characteristics
"Dopamine" is a neurotransmitter substance. According to the metabolic properties, dopamine is a precursor of adrenaline and norepinephrine. The drug affects the corresponding receptors, and in high concentration enhances the work of α- and β-adrenergic receptors. The work of "Dopamine" is aimed at:
- increased peripheral vascular resistance;
- increase in systolic blood pressure;
- stimulate heart rate;
- increased cardiac output;
- minor changes in heart rate;
- significant oxygen supply.
"Dopamine" also increases blood flow in the vessels of the brain, heart, kidneys and intestines. Increases glomerular filtration and sodium excretion in the kidneys.
"Dopamine" is a fast-acting drug. 5-10 minutes after the IV infusion, the action ends. The half-life is approximately two minutes. Half of the substance interacts with a protein in the blood plasma. The drug undergoes a process of rapid metabolism in the kidneys, liver and blood plasma due to the influence of MAO and catechol-O-methyltransferase to the state of inactive metabolites and is actively produced by the kidneys. A quarter of the dose consumed is converted to norepinephrine in the processes of the adrenergic nerves. Due to active elimination, there is no accumulation of the drug in the human body even after a long time of administration.
"Dopamine": application
Indications for admission:
- Different types of shock, including traumatic, cardiogenic, postoperative, hypovolemic, endotoxic.
- Acute vascular and heart failure.
- Low cardiac output.
"Dopamine" is especially necessary for cardiogenic shock, it increases the contractile function of the myocardium.
The drug is administered intravenously. 125 or 400 ml of a five percent glucose solution or sodium chloride solution are needed for 25 or 200 mg, respectively. Thus, in 1 ml of the solution, 200 or 500 mg of the substance will be obtained. If the patient cannot be given large volumes of fluid, moreconcentrated solution so that 1 ml contains 800 mcg of Dopamine. To do this, you need to take 200 mg per 250 ml of solutions. The rate of administration reaches 1-4 mcg / kg per minute for an average body weight of 70 kg (from 2 to 11 drops of a 0.05% solution or from 1.5 to 6 drops of a 0.08% solution). Therapeutic dosage - from 5 to 9 mcg / kg per 1 minute. The dosage of "Dopamine" 10-15 mg / kg per minute is applicable for vasodilation, as well as arterial hypotension. The rate of administration can be increased up to 18 mcg/kg per minute. The infusion takes place without interruption and is designed for a period of 2-3 hours to 1-4 days and longer. The dose per day does not exceed 800 mg. With the introduction of "Dopamine", an ECG is monitored. The determination of the dose and rate of administration occurs according to the level of blood pressure, heart rate, cardiac output, heart rate and diuresis. If arterial hypotension has not occurred, and diuresis has decreased, the dose should be reduced.
Contraindications
The drug is contraindicated in case of problems such as:
- arrhythmia;
- pheochromocytoma;
- prostate hypertrophy;
- Angle-closure glaucoma.
Side effects
Administration of a substance in large doses, high levels of "Dopamine" can cause side effects, including:
- tremor;
- tachycardia;
- vasospasm;
- arrhythmia;
- respiratory rhythm disorder;
- anginal and headache;
- psychomotor agitation;
- other manifestationsadrenomimetic action.
Because dopamine elimination is active, the above symptoms disappear if the dose is lowered or the drug is discontinued. If the rhythm is disturbed, it is necessary to use antiarrhythmic drugs, including Verapamil, Lidocaine and others. Extravasation of the Dopamine solution can lead to necrosis of the subcutaneous fat and the skin itself.
Special Instructions
"Dopamine" during pregnancy can be prescribed only when the treatment is strictly necessary for the mother, and the therapeutic effect is greater than the risk to the fetus.
Fresh mortar should have a clear consistency and no foreign tint.
Concomitant use with other drugs
The drug can be taken in parallel with cardiac glycosides and diuretics (for example, furosemide and others). Hypovolemic shock requires the administration of "Dopamine" along with whole blood, plasma or plasma substitutes.
Do not take "Dopamine" at the same time as "Cyclopropane", MAO inhibitors and anesthetics with halogen ("Ftorotan" and others).
Drug solutions should not be mixed with alkaline solutions of other drugs.
"Dopamine" is a drug that is used only on prescription. Its price depends on the dosage and the number of ampoules in the package and ranges from 80 to 300 rubles per pack (5-10 ampoules).
