Dopamine injection uses.pdf.pdf

Dopamine injection is an inotropic agent that contracts your heart muscles effectively.

This injection is one of the primary emergency drugs in emergency hospital areas to treat life-threatening medical conditions.

So, the primary use of dopamine injection is to save patient life. That’s why it is also called Life Saving Drug.

This post will describe dopamine injection uses, side effects, action, route and dose.

Dopamine belongs to a category of sympathomimetic drug or adrenergic drug. This drug contains a catechol ring, that’s why it comes in the catecholamine category.

Dopamine is a potent agonist on dopaminergic receptors (D1 and D2 receptors).

It also works on adrenergic receptors (Alpha 1 and Beta 1 receptors) that mimic the effect of the sympathomimetic nervous system.

The significant therapeutic action of dopamine injection is
-Vasoconstrictor means to increase the blood flow due to stimulation of alpha 1 adrenergic receptor

-Cardiac stimulant means to increase the heart pumping due to stimulation of beta 1 adrenergic receptor

-Nephroprotective means increasing the renal blood flow due to stimulation of the D1 receptor.

Dopamine injection is always injected into a vein through an intravenous (i.v.) route of administration. This injection must be diluted in a sterile parenteral preparation such as 5% dextrose, normal saline etc.

If you receive dopamine injections, your vital organs will be closely monitored, such as your breathing, heart rate, blood pressure, blood sugar level, oxygen levels, kidney function, etc.

Dopamine injection has the potential to cause unwanted effects or side effects.

Dopamine injection is only prescribed by an expert doctor.

You may have been given dopamine injections in emergencies such as congestive heart failure, septic shock, and cardiogenic shock with oliguria.

1. How Dopamine Injection Uses in Emergency
Conditions
Posted BySUMIT SHARMA
Contents
●Introduction
●What is dopamine injection?
●How does dopamine injection work?
●When is dopamine injection used?
❖Dopamine injection uses for congestive heart failure
❖Dopamine injection uses for septic shock
❖Dopamine injection uses for cardiogenic shocks with renal failure
●How does dopamine move through the body?
●How is dopamine injection given?

2. ●What is the action of dopamine based on doses?
❖Dopamine at a low dose
❖Dopamine at a moderate dose
❖Dopamine at a high dose
●What are the possible side effects of dopamine injection?
●What other drugs will affect dopamine?
●Who should avoid dopamine injections?
●Conclusion
●FAQ
❖Q 1. What type of drug is dopamine?
❖Q 2. Does dopamine increase BP?
❖Q 3. Can I use dopamine injection during pregnancy?
❖Q 4. Can I consume alcohol if I have used dopamine injection?
Introduction
Everyone knows thatdopamine is a happy hormone. Butdid you know that
dopamine is also used as alifesaving medicine? Today,we will learn about how
dopamine injection uses in life-threatening situations.
Suppose someone gets heart failure and is rushed to a hospital. You might have
seen symptoms in such patients asrapid heartbeat,severe shortness of breath,
sweating, chest pain, etc.

3. These symptoms indicate congestive heart failure (CHF) that occurs most
commonly due toischemic heart disease. In CHF, yourheart does not pump blood
properly. Sometimes, it is called a Heart attack.
Here, Dopamine injection is aninotropic agentthatcontracts your heart muscles
effectively.
This injection is one of the primary emergency drugs in emergency hospital areas
to treat life-threatening medical conditions.

4. So, the primary use of dopamine injection is to save patient life. That’s why it is
also called Life Saving Drug.
This post will describe dopamine injection uses, side effects, action, route and
dose.
Let’s get started.
What is dopamine injection?
Naturally, dopamine is an endogenous catecholamine neurohormone that is
produced in ourbrains.
It works as a chemical messenger that communicates information from the brain to
various body parts by neurons.
In1910, Researchers found the effect of the dopaminehormone on other body
parts such as the heart, kidney and blood vessels.
Eventually, they made a synthetic version of dopamine injection. It was first
introduced in the market with the brand name “Intropin.”

5. Dopamine belongs to a category of sympathomimetic drug or adrenergic drug. This
drug contains a catechol ring, that’s why it comes in the catecholamine category.
Dopamine is a potent agonist on dopaminergic receptors (D1 and D2 receptors).
It also works on adrenergic receptors (Alpha 1 and Beta 1 receptors) that mimic the
effect of thesympathomimetic nervous system.
How does dopamine injection work?
If we talk about the mechanism of dopamine injection, it does not cross
theblood-brain barrier(BBB), so it only works inperiphery parts (which means all
body parts except brain).
Dopamine drug directly acts on dopaminergic and adrenergic receptors.
When a doctor injects dopamine into your body, it strongly binds onα1 (alpha 1)
andβ1 (beta 1)adrenergic receptors to release noradrenalineand adrenaline.

6. Alpha 1 is mainly present in the blood vessels, and beta 1 is in our heart muscles.
Moreover, dopamine injection also works on a dopaminergic receptor that is
present on our kidneys.
The significant therapeutic action of dopamine injection is –
●Vasoconstrictor means to increase the blood flow due to stimulation of alpha
1 adrenergic receptor
●Cardiac stimulant means to increase the heart pumping due to stimulation of
beta 1 adrenergic receptor
●Nephroprotective means increasing the renal blood flow due to stimulation
of the D1 receptor

7. When is dopamine injection used?
Dopamine injection is adrug of choicein congestiveheart failure, septic shock and
cardiogenic shock with renal failure.
Let’s understand in detail –
Dopamine injection uses for congestive heart failure
Congestive heart failure (CHF) is a medical emergency that usually happens
without warning.
If your heart stops beating or cannot pump properly, this condition is called
congestive heart failure.
In this condition, dopamine is a drug of choice because it is a potent inotropic
agent that contracts your heart muscles more forcefully by stimulating the beta 1
receptor.
Due to its inotropic action, it increases stroke volume and cardiac perfusion.
Dopamine injection also acts as a chronotropic agent. This means it helps to
increase your heart rate by SA node. As result, the heart starts to beat again.
This increased heart rate and stroke volume parameters, eventually increasing
cardiac output.
CO = HR x SV
The other alternative option for CHF isdobutamineinjection. Dobutamine is also a
cardiac selective drug that only works on β1 receptor.
Dopamine injection uses for septic shock
When yourblood pressuredangerously drops due toexposure to bacterial
infection. This condition is called Septic shock.

8. Septic shock is a lethal medical condition that causes very low blood pressure. It
may also cause multiple organ failure and death.
In this septic shock condition, dopamine is again a drug of choice because it also
acts as a pressor agent.
Pressor agents are those agents that increase your blood pressure.
Here, dopamine works on the alpha-1 receptor in our blood vessels. After
administering dopamine injection, it contracts your blood vessels andincreases
blood pressureeffectively.
Dopamine injection uses for cardiogenic shocks with renal failure
Cardiogenic shock is basically a clinical feature of CHF.
Suppose someone has heart failure with kidney dysfunction. In this condition, a
person may have decreased cardiac output with reduced urine output.
Here, dopamine injection is also a drug of choice and preferable if someone has
cardiogenic with oliguria (decreased urine output).
As we discussed, dopamine works on adrenergic and dopaminergic receptors. So, it
also works on your kidney, whereD1andβ1receptorsare present.
When a doctor injects dopamine into your body, it increases the renal blood flow
and GFR (glomerular filtration rate), which increases urine output. On the heart
side, it increases cardiac output.
So, dopamine has a cardioprotective and nephroprotective properties.
How does dopamine move through the body?
It is always interesting to know the journey of a drug in the human body.

9. Let’s learn the importantpharmacokinetic parameterof dopamine injection.
As we discussed earlier, Dopamine drug comes in the sympathomimetic
catecholamine category. You can’t take catecholamine orally because these
medicines get destroyed by digestive enzymes.
Dopamine injection may be given to you only intravenous (i.v.) administration in
an emergency.
After i.v administration of dopamine, it starts working within 5 mins (onset of
action).
The health care provider needs to give a continuous infusion of dopamine injection
because itshalf-lifeis very short around 1 to 5minutes.
The 80% dopaminedrug excretesfrom the urine within24 hours.
How is dopamine injection given?
Dopamine injection is always injected into a vein through an intravenous (i.v.)
route of administration. This injection must be dilutedin a sterile parenteral
preparation such as 5% dextrose, normal saline etc.

10. The dopamine injection is available in the market in different strengths, such as
dopamine hydrochloride injection 40 mg/ml, 80 mg/ml and 160 mg/ml.
The starting infusion rate of dopamine injection is 2-5 mcg/kg/min. It means
dopamine hydrochloride delivers 2 to 5 mcg in your blood every minute.
The infusion rate of dopamine can be gradually increased in more serious patients.
It can be given 5 to 10 mcg/kg/min and go up to a rate of 20 to 50 mcg/kg/min as
needed.
Health care provider needs to be cautious while handling dopamine injection.
Dopamine injection should not be added with sodium bicarbonate or alkalinizing
substance because dopamine gets inactivated in an alkaline solution.
What is the action of dopamine based on doses?

11. The dose of dopamine is always a concern while you are receiving dopamine
injections.
Because the effect of dopamine injection is changed at different doses.
Let me explain in a nutshell.
Dopamine at a low dose
If you receive dopamine injections at a low dose (2-5 mcg/kg/min), it will give you
a better effect on the kidney and a mild effect on your heart.
Of course, it would be better if someone has anoliguriaand struggling with
cardiogenic shock.
Dopamine at a moderate dose
The effect of dopamine will be changed if it slightly increases in dopamine dose.
So, a moderate dose of dopamine (5 to 10 mcg/kg/min) may have a positive
inotropic effect on your heart by directly acting on the Beta 1 adrenergic effect.
It will be an appropriate dose if someone has acute congestive heart failure.
Dopamine at a high dose
The high dose of dopamine injection (more than 10 mcg/kg/min) may give a
vasoconstrictive effect by directly acting on alpha 1 adrenergic effect.
This high dose of dopamine is beneficial if you get a septic shock.
What are the possible side effects of dopamine injection?

12. If you receive dopamine injections, your vital organs will be closely monitored,
such as your breathing, heart rate, blood pressure,blood sugar level, oxygen levels,
kidney function, etc.
Dopamine injection has the potential to cause unwanted effects or side effects.
The following general side effects can be noticed after receiving this medication
such as –
●Restlessness
●Anxiety
●Dizziness
●Headache
●Palpitation
This medicine also has the potential to cause some severe side effects, such as –
●Hypertensionandhypertensive crisis
●Cardiac arrhythmias–ventricular arrhythmias, tachyarrhythmia
●Stroke
●Hyperglycaemia (Increasedblood glucose)
●Tissue necrosis and sloughing (if a dopamine injection given IV leaks into
the surrounding tissue).

13. Tell your doctor immediately if you experience any of these severe symptoms.
You may also be given a phentolamine injection to prevent local tissue necrosis
from dopamine injection.
What other drugs will affect dopamine?
Dopamine injection can interact with other drugs.
There are two critical situations where a doctor needs to give more attention while
giving dopamine injections to a patient.
Situation 1 – dopamine injection with phentolamine
Suppose a doctor gives you a phentolamine injection to counter dopamine’s tissue
necrosis side effects.
In this condition, you may have a hypotension problem because phentolamine is an
antiadrenergic alpha-blocker that decreases rising blood pressure.
Situation 2 – dopamine injection with MAO inhibitors
Dopamine drug also has an important concern withMAOinhibitorsdrugs (such as
selegiline, phenelzine, and tranylcypromine) or otherantidepressant drugs.
Generally, dopamine is metabolized by MAO (Monoamine oxidase) enzyme.
If someone is already taking MAO inhibitors medicines and receiving dopamine
injections. In that case, there is a chance of dopamine toxicity.
The person will be experienced severe tachycardia and hypertension.
Who should avoid dopamine injections?

14. Dopamine injection is contraindicated in certain medical conditions. So, you must
tell your doctor about your medical history before receiving a dopamine injection.
1. Avoid dopamine injection in diabetic condition
Suppose someone has a diabetic history and that person receives a dopamine
injection. In that case, a doctor needs to increase theinsulinor otherantidiabetic
drugsdose because dopamine injection increases bloodsugar levels.
2. Avoid dopamine injection in pheochromocytoma condition
Pheochromocytomais a tumour where chromaffin cellsof the adrenal gland make
a cluster.
This cluster of chromaffin cells releases a massive amount of noradrenaline and
adrenaline that produce severe hypertension.
If you receive dopamine injection in this condition, it will increase immense blood
pressure, which may be fatal.
3. Avoid dopamine injection in tachyarrhythmia condition
Dopamine drug is a cardiac stimulant that increases heart rate. So, you should tell
your doctor if you already have arapid heart rateproblem before receiving a
dopamine injection.
Conclusion
We have seen how dopamine injection uses in critical conditions.
Dopamine injection is only prescribed by an expert doctor. You may have been
given dopamine injections in emergencies such as congestive heart failure, septic
shock, and cardiogenic shock with oliguria.

15. It is generally used in different units of hospitals, such as the emergency
department, ICU, critical care unit, cardiac unit, etc. It can also be found in an
ambulance.
This is only an informative article.
Being a pharmacist, I have mentioned all the important points about dopamine
injection.
For more information, you must consult your doctor.
If you found this post informative, please share it on social media.
FAQ
Q 1. What type of drug is dopamine?
Dopamine is a prescription medicine that is used in emergencies such as heart
attack, very low blood pressure, etc.
Q 2. Does dopamine increase BP?
Yes. Since dopamine injection has a vasoconstrictive effect by binding on alpha 1
adrenergic receptor. So, it effectively increases your blood pressure.
Q 3. Can I use dopamine injection during pregnancy?
Inanimal studies of dopamine injection, no teratogenicrisk was found. While there
is a lack of safety data on dopamine injection in human beings. Therefore,
dopamine injection can be used inpregnancyif thebenefit outweighs the risk.
Q 4. Can I consume alcohol if I have used dopamine injection?
Although alcohol itself increases the dopamine level in our brain. There is no data
about alcohol and dopamine injection interaction. Since dopamine injection is used

16. in an emergency, you must have had a life-threatening condition. It is better to ask
your doctor if you have a habit of regular drinking.
References –
1. KD Tripathi.Essentials of Medical Pharmacology,7thJaypee Brothers Medical
Publishers (P) Ltd; 2013. Drugs acting on autonomic nervous system (Section 2):
Adrenergic System and Drugs, Chapter-9; Page – 124 to 139.
2. Lippincott Williams & Wilkins.Nursing Pharmacology:Made incredibly easy,
3rdWolters kluwer health; 2013. Autonomic nervoussystem drugs, chapter – 2;
Page – 40 to 46.
3.Dopamine hydrochloride and 5% dextrose injectionUSP. FDA; Hospira 2004,
Reference ID: 3506755.
Read more posts…