UMEM Educational Pearls

Category: Critical Care

Title: Dopamine

Keywords: dopamine, hemodynamic medication, vasopressors (PubMed Search)

Posted: 11/18/2008 by Mike Winters, MD (Updated: 10/22/2020)
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Dopamine in the ED

  • Recall that dopamine is an endogenous catecholamine that is a precursor for norepinephrine synthesis
  • Despite the popularity of norepinephrine, dopamine is still used by many EPs in the setting of septic shock
  • Dopamine produces progressive alpha-receptor stimulation at doses > 10 mcg/kg/min
  • Tachyarrhythmias (namely sinus tachycardia) is the predominant adverse effect
  • When selecting a vasopressor agent, be sure to check the HR.  If the patient is already tachycardic, the addition of dopamine will only worsen the tachycardia
  • Additional important adverse effects are increased intraocular pressure and delayed gastric emptying

References

Marino PL.  Hemodynamic drugs. In: The Little ICU Book of Facts and Formulas. 2009 Ed. Lippincott Williams & Wilkins, Philadelphia, PA.