ドパミン

使用用途

• Vasodilatory shock if fluid resuscitation and dobutamine is not successful
• Treatment of severe hypotension/shock
• Treatment of severe hypotension/shock after fluid correction and if dobutamine does not give desired effect
• Vasodilatory shock if fluid resuscitation and dobutamine is not successful
• Adjunctive therapy for acute heart failure
• Treatment of severe hypotension/shock
• Treatment of severe hypotension/shock after fluid correction and if dobutamine does not give desired effect
• Adjunctive therapy for oliguric renal failure

投与方法

考えられる副作用

• Nausea and vomiting
• Ectopic beats (arrhythmias)
• Tachycardia
• Palpitations
• Hypotension (at low doses) or Hypertension (at high doses)
• Dyspnea
• Vasoconstriction (reduced peripheral circulation)
• Severe tissue necrosis and sloughing (if extravasated)

注意事項と禁忌

• Pheochromocytoma
• Ventricular fibrillation
• Uncorrected tachyarrhythmias
• Uncorrected hypovolemia (must replace fluids first)
• ### Critical Warnings * **Extravasation Risk**: Extravasation can cause severe ischemic tissue necrosis and sloughing. Monitor IV sites continuously. If extravasation occurs, infiltrate the ischemic area with 5-10 mg **phentolamine** diluted in 10-15 mL of normal saline using a fine needle with multiple subcutaneous injections. * **Hypovolemia**: Dopamine is *not* a substitute for adequate fluid, electrolyte, or blood product replacement. Volume deficits must be corrected prior to use. * **Cardiovascular Disease**: Use with extreme caution in patients with ischemic heart disease or occlusive vascular disease. Discontinue or reduce dose if arrhythmias (e.g., PVCs) occur or if signs of reduced peripheral circulation develop. * **Feline Renal Failure**: Cats are unlikely to benefit from low-dose dopamine for oliguric renal failure, and it may be detrimental.

薬物相互作用

• Alpha-adrenergic blockers (e.g., prazosin): May antagonize the vasoconstrictive properties of high-dose dopamine.
• Halogenated hydrocarbon anesthetics (e.g., halothane): May result in increased incidences of ventricular arrhythmias.
• Tricyclic antidepressants: May potentiate adverse cardiovascular effects.
• Beta-blockers (e.g., propranolol, metoprolol): May antagonize the cardiac (inotropic/chronotropic) effects of dopamine.
• Diuretics: May potentiate urine production effects of low-dose dopamine.
• Monoamine oxidase inhibitors (MAOIs): Can significantly prolong and enhance the effects of dopamine.
• Oxytocic drugs: May cause severe hypertension when used concurrently.
• Phenothiazines: May antagonize the renal and mesenteric vasodilatation effects of dopamine.
• Vasopressors/Vasoconstrictors: Concurrent use may cause severe hypertension.

よくある質問