Dopamine (dove)-200mg/5ml Inj

Action Indications Contraindications Route/Dosage Interactions Lab Test Interferences Adverse Reactions Precautions Patient Care Considerations Administration/Storage Assessment/Interventions Patient/Family Education (DOE-puh-meen HIGH-droe-KLOR-ide) Intropin, Revimine Class: Vasopressor Action Stimulates beta1 receptors in heart, causing more complete and forceful contractions (inotropy). Also acts on alpha receptors (dose dependent) and has dopaminergic effects. Indications Correction of hemodynamic imbalances present in shock after MI; trauma, endotoxic septicemia, surgery and renal failure or imbalances in conditions of chronic refractory cardiac decompensation (eg, CHF). Contraindications Pheochromocytoma; uncorrected tachyarrhythmias; ventricular fibrillation. Route/Dosage ADULTS: IV Initial dose: 2 to 5 mcg/kg/min with incremental changes of 5 to 10 mcg/kg/min at 10 to 15 min intervals until adequate response is noted. Most patients are maintained at < 20 mcg/kg/min. If dosage exceeds 50 mcg/kg/min, assess renal function frequently. Interactions Furazolidone, methyldopa, rauwolfia alkaloids: Hypertension may result. Guanethidine: Antihypertensive effects of guanethidine may be negated. Monoamine oxidase inhibitors: May greatly increase pressor response from dopamine. Phenytoin: Severe hypotension and bradycardia may result after concomitant administration with dopamine. Tricyclic antidepressants: May decrease pressor response from dopamine. Incompatibilities: Chemically incompatible with alkaline solutions (drug is inactivated). Lab Test Interferences None well documented. Adverse Reactions CV: Ectopic beats; tachycardia; anginal pain; palpitation; hypotension; vasoconstriction; ventricular arrhythmias (at high doses); hypertension. CNS: Headache; anxiety. EENT: Dilated pupils (at high doses). GI: Nausea; vomiting. GU: Decreased urine output. RESP Dyspnea. OTHER: Gangrene of extremities. Precautions Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Special risk patients: Do not give in presence of uncorrected tachyarrhythmias or ventricular fibrillation. Extravasation: Avoid by infusing into large vein and monitoring infusion carefully. Sulfite sensitivity: Use caution in sulfite-sensitive individuals; some commercial preparations contain sodium bisulfite. PATIENT CARE CONSIDERATIONS Administration/Storage Administer by IV infusion only. Metering device is essential for controlling rate of flow. Dopamine is potent drug. Dilute before use if not prediluted. Dilute medication just prior to administration. Solution is stable for 24 hr after dilution. Do not use if solution is discolored. Store at room temperature and protect from light. Discard dissolved solution. Assessment/Interventions Obtain patient history, including drug history and any known allergies. Monitor vital signs and ECG closely throughout therapy. Monitor I&O regularly. Notify physician promptly if urine output decreases. Monitor IV rate for free flow throughout administration. Monitor central venous pressure or pulmonary wedge pressure if possible during infusion. Observe infusion site for extravasation. If extravasation occurs, treat by infiltrating the area with 10 to 15 ml of normal saline containing 5 to 10 mg of phentolamine. Notify physician immediately if these signs occur: significant changes in vital signs, ECG changes (arrhythmias, tachycardia); deterioration of peripheral pulses and cold, mottled extremities. OVERDOSAGE: SIGNS & SYMPTOMS Hypertension Patient/Family Education Instruct patient to inform nurse immediately if these signs occur: chest pain, dyspnea, numbness, tingling or burning of extremities and discomfort at IV site.