Dopamine

Dopamine – cardiotonic and hypertensive drug.

Form of release and structure

Dosage form – a concentrate for preparation of solution for infusions: the transparent, slightly painted or colourless liquid (on 5 ml in glass colourless ampoules, in a blister strip packaging or cardboard a tray on 5 ampoules, in a cardboard pack 1 either 2 packagings or trays; on 5 or 10 ampoules in a cardboard box or a pack).

Active ingredient of the Dopamine – a dopamine a hydrochloride, in 1 ml – 5 mg, 10 mg, 20 mg or 40 mg.

Auxiliary components: Acidum hydrochloricum solution of 0,1 M (to pH 3,5-4,0), sodium disulphite, water for injections.

Indications to use

• Acute form of cardiovascular insufficiency of various etiology;
• Cardiogenic, anaphylactic, infectious and toxic, hypovolemic (after recovery of volume of the circulating blood), postoperative shock;
• Arterial hypotension;
• Syndrome of low cordial emission at patients of a heart surgery;
• Increase in a diuresis at poisonings.

Contraindications

• Hypertrophic subaortic stenosis;
• Pheochromocytoma;
• Fibrillation of ventricles;
• Individual intolerance of a dopamine.

With care it is recommended to appoint the Dopamine sick with disturbance of a cordial rhythm (a tachyarrhythmia, ventricular arrhythmia, fibrillation of auricles), a hypovolemia, a metabolic acidosis, a myocardial infarction, a hypercapnia, hypertensia in a small circle of blood circulation, a hypoxia, a thyrotoxicosis, a prostate hyperplasia, a diabetes mellitus, closed-angle glaucoma, occlusal diseases of vessels (including freezing injury, a thrombembolia, the atherosclerosis obliterating a thromboangitis, a diabetic endarteritis, an obliterating endarteritis, a Raynaud's disease), bronchial asthma (at hypersensitivity to disulphite in the anamnesis); during pregnancy and breastfeeding; aged up to 18 years.

Route of administration and dosage

Ready solution of the Dopamine is entered intravenously kapelno.

The mode of dosing and the period of use are appointed by the doctor on the basis of clinical indications individually taking into account the size of the arterial pressure (AP), reaction of the patient to drug, severity of shock.

For increase in contractility of a myocardium and a diuresis the recommended dose makes 0,1-0,25 mg/min., in need of impact on the ABP the dose is lifted to 0,3-0,5-0,7 mg/min. For adult patients the maximum dose should not exceed 1,5 mg/min.

To children appointment is made taking into account the child's weight – on 0,004-0,006 mg on 1 kg a minute.

Use of a dopamine can last up to 28 days.

Side effects

• Cardiovascular system: decrease or increase in the ABP, bradycardia or tachycardia, pains behind a breast, conductivity disturbances, expansion of the QRS complex, increase in end diastolic pressure in a left ventricle, a vasospasm; at high doses – supraventricular or ventricular arrhythmia;
• Nervous system: more often – a headache; less often – motive concern, uneasiness, a tremor of fingers of hands;
• Alimentary system: nausea, vomiting, bleedings from digestive tract;
• Allergic reactions: at patients with bronchial asthma – a bronchospasm, shock;
• Metabolism: polyuria;
• Local reactions: a necrosis of skin and hypodermic cellulose at hit of solution under skin;
• Others: less often – an azotemia, an asthma, a piloerektion; seldom – a polyuria (at therapy in low doses).

Special instructions

Use of the Dopamine at a hypovolemia can be begun only after compensation of volume of the circulating blood.

Administration of solution needs to be accompanied with careful control of heart rate, the ABP, an electrocardiography, size of a diuresis, pulmonary pressure, a stroke output of heart, filling pressure of ventricles, the central venous pressure.

At decrease in a diuresis it is necessary to lower a dopamine dose.

At simultaneous use of monoamine oxidase inhibitors (MAO) the dose of a dopamine is required to be reduced by 10 times.

Medicinal interaction

At simultaneous use of the Dopamine:

• Diuretics: strengthen diuretic effect of drug;
• Furasolidone, селегилин, Procarbazinum and other MAO inhibitors, гуанетидин: can strengthen duration and intensity of the cardiostimulating and pressor effect of a dopamine;
• Octadinum: increases sympathomimetic action of a dopamine;
• Cyclopropane, энфлуран, chloroform, a halothane, метоксифлуран, изофлуран and other inhalation means for the general anesthesia (derivatives of hydrocarbons): increase risk of emergence of heavy disturbances of a cordial rhythm;
• Hormones of a thyroid gland: can strengthen the action and action of a dopamine;
• Levodopa: the probability of development of arrhythmias increases;
• Beta adrenoblockers derivative of phenyl propyl ketone: reduce action of a dopamine;
• Cocaine and other sympathomimetics: strengthen cardiotoxic effect of drug;
• Cardiac glycosides: can promote increase in risk of development of disturbances of a cordial rhythm;
• Oxytocin, ergometrine, methylergometrine, ergotamine: increase vasopressor effect, risk of emergence of ischemia and gangrene, heavy arterial hypertension, up to threat of intracraneal hemorrhage;
• Maprotilinum and other tricyclic antidepressants: strengthening action of a dopamine, can cause development of arrhythmia, tachycardia, heavy arterial hypertension;
• Phenytoinum: the risk of development of heavy arterial hypotension increases;
• Guanetidin, guanadret, Methyldopum, Rauwolfia alkaloids: their hypotensive effect decreases.

The dopamine reduces anti-anginal effect of nitrates, and those, in turn, reduce pressor effect of sympathomimetics, increasing risk of development of arterial hypotension.

Solution is incompatible with oxidizers, iron salts, alkaline solutions, thiamin.

Terms and storage conditions

To store at a temperature up to 25 °C. To protect from children.

Period of validity – 3 years.