#建議持續輸注 (IV pump) 之高警訊藥品

Hypotension or shock: Treatment of severe hypotension or shock that persists during and after adequate fluid volume replacement (septic shock, cardiogenic shock, decompensated heart failure, post–cardiac arrest)

Adrenergic Agonist Agent; Inotrope
Dopamine is a neurotransmitter in some areas of the central nervous system and is also a precursor to norepinephrine in noradrenergic nerves. It produces a positive inotropic and chronotropic effects on the myocardium by exerting an agonist action on beta-adrenoceptors and releasing norepinephrine from storage sites in sympathetic nerve endings, thus increasing heart rate and cardiac contractility. It also stimulates alpha-adrenoceptor activity with consequent vasoconstrictor effects and rise in blood pressure.

1. Onset of action: Within 5 minutes
2. Duration: <10 minutes
3. Metabolism: Renal, hepatic, plasma; 75% to inactive metabolites by monoamine oxidase and 25% to norepinephrine (active)
4. Half-life elimination: ~2 minutes
5. Excretion: Urine (as metabolites)
6. Clearance: Age related; clearance is prolonged with combined hepatic and renal dysfunction

1. Pheochromocytoma, tachyarrhythmias, or ventricular fibrillation
2. Simultaneous administration of blood through the same infusion set, coadministration of dextrose solutions without electrolytes and blood may result in pseudoagglutination of red cells

Medications required for the treatment of critically ill pregnant patients should not be withheld due to concerns of fetal teratogenicity.

It is not known if dopamine is present in breast milk.

Nausea, vomiting, ectropic beats, palpitation, tachyarrhythmia, chest pain, dyspnea, headache, hypertension.

Inotropic support:
(Continuous IV infusion) 5 to 15 mcg/kg/minute; doses at lower end of this range are preferred as inotropic actions predominate at lower doses and vasoconstrictive actions predominate at higher doses
Cardiogenic shock (alternative agent):
Note: Typically not the preferred initial agent due to increased arrhythmias and possibly mortality in this population.
(Continuous IV infusion) 0.5 to 20 mcg/kg/min; titrate based on clinical end point (eg, end-organ perfusion)
Septic shock and other vasodilatory shock states (alternative agent):
Note: Not recommended as an alternative to norepinephrine in patients with bradycardia who have a low risk of tachyarrhythmias. Compared to norepinephrine, dopamine is associated with an increased risk of tachyarrhythmias, increased mortality, and kidney failure.
(Continuous IV infusion) Initial 2 to 5 mcg/kg/min; titrate to goal MAP up to a dose of 20 mcg/kg/min
Post-cardiac arrest shock (alternative agent):
Note: Typically not the preferred initial agent due to risk of tachyarrhythmias.
(Continuous IV infusion) 5 to 20 mcg/kg/min

Hemodynamic support:
(Continuous IV or intraosseous infusion) 2 to 20 mcg/kg/minute, titrate gradually by 5- to 10-mcg/kg/minute increments until optimal response is obtained; the hemodynamic effects of dopamine are dose-dependent:
(1) 1-5 mcg/kg/min: increased renal blood flow and urine output
(2) 5-15 mcg/kg/min: increased renal blood flow, heart rate, cardiac contractility, cardiac output, and blood pressure
(3) >15 mcg/kg/min: alpha-adrenergic effects begin to predominate, vasoconstriction, increased blood pressure

Not mentioned

Not mentioned