dopamine hydrochloride

CLINICAL USE

Cardiogenic shock in infarction or cardiac surgery

DOSE IN NORMAL RENAL FUNCTION

Initially 2–5 mcg/kg/minute

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :189.6

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :No data

%Excreted unchanged in urine &nbsp &nbsp : Minimal

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :No data

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :2 min/–

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 &nbsp &nbsp : Dose as in normal renal function

10 to 20 &nbsp &nbsp : Dose as in normal renal function

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in normal renal function

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in normal renal function

HDF/high flux &nbsp :Not dialysed. Dose as in normal renal function

CAV/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAlpha-blockers: avoid concomitant use with tolazoline Antidepressants: risk of hypertensive crisis with MAOIs and moclobemide Ciclosporin: may reduce risk of ciclosporin nephrotoxicityDopaminergics: effects possibly enhanced by entacapone; avoid concomitant use with rasagiline; risk of hypertensive crisis with selegiline

ADMINISTRATION

Reconstition

–

Route

IV peripherally into large vein (centrally for inotropic dose). Central route always preferable

Rate of Administration

Via CRIP as indicated below

Comments

Minimum dilution 200 mg in 50 mL Not compatible with sodium bicarbonate – rapid deactivation of dopamine

OTHER INFORMATION

Renal dose is 2–5 mcg/kg/min but little evidence that it can improve renal function Causes renal vasoconstriction at inotropic dose Cardiac and BP monitoring advised Very severe tissue damage caused by extravasation

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