Dopamine, 40 mg/ml concentrate 5 ml 10 pcs

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Indications

– Shock of different genesis: cardiogenic, postoperative, infectious-toxic, anaphylactic, hypovolemic (only after restoration of circulating blood volume);

– acute cardiovascular failure, “low minute circulation volume” syndrome in cardiac surgery patients;

– acute arterial hypotension.

Active ingredient

Composition

How to take, the dosage

It is administered by intravenous drip.

The dose is set individually, depending on the severity of shock, the value of blood pressure and patient’s response to treatment.

To obtain the inotropic effect, administer at a rate of 100-250 mcg/min (1.5-3.5 mcg/kg/min), a low-dose area.

In intensive surgical therapy, 300-700 mcg/min (4-10 mcg/kg/min) is the area of medium doses; in septic shock, 750-1500 mcg/min (10.5-21 mcg/kg/min) is the area of maximum doses.

If cardiac rhythm abnormalities occur, regardless of the doses used, further dose increases are contraindicated.

In most patients a satisfactory condition can be maintained with doses of Dopamine less than 20 mcg/kg/min.

Length of use: the duration of administration is determined individually. There is a positive experience of infusion duration up to 28 days. Once the clinical situation has stabilized, the drug should be withdrawn gradually.

Rules for solution preparation: for dilution use 0.9% sodium chloride solution, 5% dextrose (glucose) solution (including their mixtures), 5% dextrose (glucose) solution in Ringer lactate solution, sodium lactate and Ringer lactate solution.

In order to prepare a solution for intravenous infusion, 400-800 mg of Dopamine must be added to 250 ml of solvent (Dopamine concentration will be 1.6-3.2 mg/ml). The infusion solution should be prepared immediately prior to administration (the solution is stable for 24 h, except when mixed with Ringer’s lactate solution – maximum 6 h).

The Dopamine solution should be clear and colorless.

Interaction

Dopamine may potentiate the effects of diuretics.

Dopamine weakens the antihypertensive effect of guanadrel, guanethiline, mecanilamine, methyldopa, rauwolfia alkaloids (the latter prolong the effect of dopamine).

In concomitant use with levodopa – increased risk of arrhythmias; with thyroid hormones – possible increase in the effect of both dopamine and thyroid hormones.

Phenytoin may contribute to arterial hypotension and bradycardia (depending on the dose and speed of administration); ergot alkaloids to vasoconstriction and gangrene.

With cardiac glycosides there may be an increased risk of arrhythmias, additive inotropic effect (ECG monitoring required).

Decreases the antianginal effect of nitrates, which in turn may decrease the pressor effect of sympathomimetics and increase the risk of arterial hypotension (simultaneous use is permitted depending on achieving the therapeutic effect).

Pharmaceutical Incompatibilities

Incompatible with acyclovir, alteplase, amikacin, amphotericin B, ampicillin, cephalothin, dacarbazine citrate, theophylline ethylenedamide (eufylline), calcium theophylline (eufylline calcium), furosemide, gentamicin, sodium heparin, sodium nitroprusside, benzylpenicillin, tobramycin, alkaline solutions, oxidizing agents, iron salts, thiamine (promotes its destruction).

Special Instructions

Dopamine is intended for intravenous infusions only and may only be used diluted!

Dopamine improves atrial-ventricular conduction, so patients with atrial fibrillation should be given cardiac glycosides before using the drug; hypoxia, hypercapnia, and acidosis reduce the effectiveness of dopamine, increasing the potential for side effects.

Hypovolemia should be corrected by administration of plasma and other blood substitute fluids before administration in patients who are in shock.

Infusion should be performed under control of diuresis, minute blood volume; blood pressure, ECG, HR. Decreased diuresis without a concomitant decrease in blood pressure indicates the need to reduce the dopamine dose.

Moamine oxidase inhibitors, by increasing the pressor effect of sympathomimetics, may cause headache, arrhythmias, vomiting, and other manifestations of hypertensive crisis, so in patients who have received monoamine oxidase inhibitors for the last 2-3 weeks, the initial dopamine dose should be no more than 10% of the usual dose.

In order to reduce the risk of extravasation, the drug should be injected into large veins whenever possible. To prevent tissue necrosis in case of extravasal ingestion of the drug, 10-15 ml of 0.9% sodium chloride solution with 5-10 mg of phentolamine should be infiltrated immediately.

The use of the drug against a background of peripheral vascular obliterative diseases and/or a history of dyssymptomatic intravascular clotting may cause severe and pronounced vasoconstriction, leading to skin necrosis and gangrene (close monitoring should be performed and the drug administration should be stopped immediately if signs of peripheral ischemia are detected).

Dopamine is a drug for inpatient use with a very short half-life. After discharge from hospital, there is no possibility of the drug affecting reaction speed when driving motor vehicles or operating other mechanisms.

Contraindications

– Hypersensitivity to the components of the drug, including. to sulfites;

– hypertrophic obstructive cardiomyopathy;

– pheochromocytoma;

– thyrotoxicosis;

– tachyarrhythmia;

– ventricular fibrillation of the heart.

– closed-angle glaucoma;

– concomitant use of cyclopropane and hydrocarbon derivatives for inhalation anesthesia, ergot alkaloids.

– age under 18 years (efficacy and safety not established).

. Hypovolemia, myocardial infarction, cardiac rhythm disorders (ventricular arrhythmias, atrial fibrillation), marked aortic stenosis, metabolic acidosis, hypercapnia, hypoxia, arterial hypotension in the “small” circuit of the circulation, Obliterating vascular diseases (including atherosclerosis, thromboembolism, obliterating thrombangitis, obliterating endarteritis, diabetic endarteritis, Raynaud’s disease, frostbite), diabetes, pregnancy, breast-feeding.

Side effects

Cardiovascular system disorders: tachycardia or bradycardia, palpitations, chest pain, angina pectoris, increased or decreased blood pressure, conduction disorders, dilated QRS complex; vasospasm, increased left ventricular end-diastolic pressure; when used in high doses – ventricular or supraventricular arrhythmias.

Gastrointestinal tract: nausea, vomiting, bleeding from the gastrointestinal tract.

Central and peripheral nervous system: headache; anxiety, motor restlessness, hand tremor.

Allergic reactions: severe hypersensitivity reactions and bronchospasm (due to the presence of sulfites in the drug), shock.

Local reactions: if dopamine gets under the skin – necrosis of the skin, subcutaneous tissue, gangrene may develop.

Others: dyspnea, azotemia, piloerection, polyuria (when administered in low doses).

Overdose

Symptoms: excessive increase in blood pressure, peripheral arterial spasm, arrhythmia, tachycardia, ventricular extrasystoles, angina pectoris, dyspnea, headache, psychomotor agitation.

Treatment: due to rapid elimination of dopamine from the body these phenomena are controlled by dose reduction or discontinuation of administration; if ineffective – short-acting alpha-adrenoblockers (for excessive increase in blood pressure) and beta-adrenoblockers (for arrhythmia).

Pregnancy use

Similarities