Dopamine (Inotropin) Nursing Considerations
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Outline
Generic Name
dopamine
Trade Name
Inotropin
What is the indication for Dopamine?
used to improve blood pressure, cardiac output, and urine output
Action
Smaller doses result in renal vasodilation
Doses 2-10mcg/kg/min result in cardiac stimulation by acting on beta1 receptors
Doses >10mcg/kg/min stimulate alpha receptors leading to vasoconstriction (↑SVR)
What is the therapeutic class for Dopamine?
inotropic, vasopressor
Pharmacologic Class
adrenergic
Nursing Considerations for Dopamine (Inotropin)
• Monitor hemodynamics closely: BP, HR, EKG, CVP, and PAOP if available
• Obtain parameters for hemodynamic values
• Titrate to obtain appropriate BP (more potent vasoconstrictors may be required)
• Irritation may occur at IV site
• Beta blockers may counteract therapeutic effects
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Transcript
Let’s take a look at dopamine, also known as Inotropin. This is an IV medication, as you can see here with the vial. So remember when we talk about the therapeutic class, we’re talking about the way the drug works in the body while the pharmacologic class is the chemical effect of the drug. So the therapeutic class of dopamine is an inotropic agent, as well as a vasopressor and the pharmacologic class is adrenergic. So it’s important to mention that dopamine in smaller doses does result in renal vasodilation, doses between two and 10 mcg/kg/minute results in cardiac stimulation, while doses that are greater than 10 mcg/kg/min stimulates alpha receptors leading to vasoconstriction. So dopamine, depending on the dose, is indicated to improve blood pressure, cardiac output, and urine output.
With dopamine, we do see some side effects which can include arrhythmias, anxiety, nausea, and headache. So let’s take a look at a few nursing considerations for dopamine. You must monitor the hemodynamics closely, which would include blood pressure, heart rate, EKG, CVP, or central venous pressure, pulmonary artery occlusion pressure, or PAOP. And with this, make sure you know what the parameters are for the hemodynamic values that you are monitoring closely. So with dopamine, we are able to titrate the medication to get the desired blood pressure, but sometimes more potent vasoconstrictors are needed to achieve that desired blood pressure. Dopamine does interact with beta-blockers as beta-blockers can counteract to therapeutic effects of dopamine. So keep this in mind and make sure to teach your patient signs of a reaction which include wheezing, chest tightness, fever, and itching. Guys. I can remember when I was working in the ICU, a fellow nurse infused dopamine and dobutamine, which led to questioning an order that was given, which ended up really making the nurse feel embarrassed. I do not want that to happen to you. So remember there is a difference between these two medications. Guys, dopamine has an alpha effect while dobutamine has a beta effect. Check out our other lesson on dobutamine.
That’s it for dopamine or Inotropin. Now go out and be your best self today. And as always happy nursing.
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Pharmocology
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12 Points to Answering Pharmacology Questions
54 Common Medication Prefixes and Suffixes
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
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