Dopamine

    Dopamine  !"#$ % drip  rate $ ) * + ,# - %.$
-!/  ( !",$ ,# - ) $ keep BP> 90/60 , keep BPS> 100 =>  ( $/!  order )$)- !")


 1

 Dopamine 2 : 1  % AB  % C C / # Dopamine 2 mg (2000 mcg)  FG 1 ml
 I/- dopamine /
- 200 mg 10 ml  ! CB!J 1 amp *C C   FG 100 ml
 ,G #K rate  ! J%  #$ % % *)$
 ! 10-20 mcg/kg/min ()*+,
-. 30 mcg/kg/min
 $ / /F)$)- !" FG %  # %,J- FG % =  K 50 JMC 
,G #K  minimum dose (10 mcg) $ ! 500 mcg/min = 0.5 mg/min
  K/QB+ /F  15 ml/hr ,J-=> / )- 0.25 ml x 200 mg  / # 0.5 mg/min UB$ ! dose
#)=  =$ W
V %
 order /F,*  ! C!J AB 10 amp UB 1 amp   drip  )-AB 6-7 . ! 1 # 
4 amp + stat )=C# 1 amp ,# !J=  K 5 amp $ F


 2

1
 Dopamine UB/,# 

 %*  K/QB+ / 1  $ /  drip  / #$  6
microdrop/min  /!$ ! 6 ml/hr.
 G % ! order /F,*  !" = !
- M- )  
J
BF , FC 2 microdrop/min * + -!,# - %.$ $# 90/60


 3

 Dopamine // $# 1: 1  % AB %/ # Dopamine 1 mg  FG 1 ml

 I/- dopamine /
- 200 mg 10 ml  ! CB!J 1 amp / 5 ml *C C   FG 100 ml
 K/ /F /%C*.$ 5 ml )$ G %\!)# syringe  #$  ^, FA-)=/*! ½ #
C  I/- J-/ => ampule *=`- C# )$ G %\!)#  , FA-)=


 4

 one day * $ ^.=a# -J B)$)- !"
- /   $ * => High alert drug UB /
 # !
- c ,#  review order -J C M !A  ! CAB rate   C 3!456-*67
-8 !9.:)
;!9<!.

2


 5

 Dopamine 2 : 1 rate 30 ml/hr */!! K/QB+ / 1 (rate 30 ml/hr )  !#$  rate  #$
1 $  $.$ $#/ !)-)$J max dose (,G #K  FG %  # 50 . )- 20 mcg/kg/min )


 6

  Dopamine // $# 1.6 : 1  % AB %/ # Dopamine 1.6 mg  FG 1 ml
UBA -J/ premixed  /!$ ! Dopamine premixed 400 mg D5W 250 ml  K/ /F/ 2  C*,*
1. = B+  ! C*  =>  $# 2:1  G % )$%C*C ,G #K$ #$ 1.6 :1
2. !J 1 amp (200mg) C -.-  8 ml (160mg) *^! FG 100 ml


 7

3
 Dopamine 4 : 1  % AB  % C C / # Dopamine 4 mg (4000 mcg)  FG 1 ml
^.=a#  /F $  / G - FG B ^  $# 4 :1  $   J !" *
,?!*?!.@A5@B;)5,C45 C4 3.2 mg/mL (3200 mcg) ^.= a#/G - FG B  -. rate ,#!,.$)=-# 
8 microdrop/min = 533 mcg/ min UB.$ $#/ !)- (-. #$  ,G #K  K/QB+ / 1)

@B
.@49 Dopamine ?45,D@


1. ,G #K rate  ! J%  #$ %  .$ $#/ !)-% *)$
2. J K  !J FG / ^ #$ !J = J K/ J )=% *)$
3. A )$/ C /- ! J%   #! %CC M A  ! C*
 C /-/-

Dopamine Injection
C4
! Dopamex injection
C46!45 Dobutamine (  indication $  )
A(99()*(5  J-I/- 200 mg  C C  10 ml (20 mg 1 mL)
-J/ Dopamine premixed 200 mg C 400 mg D5W 250 ml  $=V"! )$)-
G 
 !W/ M  ! C
?!49+5 !
1.  + ^.=a# c # Shock //   *  % " $ l $ shock  *  %C-C*-
%# "-  C  *F%#   => 
2.  + ^.=a#,# - MC%J G $  "  C =m   Shock / J- 
3. !^.=a#M ,%# C M ,)  *F  /J-  "  $   %
4.  + ^.=a# J+
 $   + M ,%#  ! !J. , M!  C C  J+ * l /
  A
! ) )-
5. $# " 
!A$ =V # %=> = J-/
BF

44
H8-I?45 =>  C"$ " F # ! alpha C beta - adrenergic G %%C-C*-$# =C 

/! J !/! #
%#  J )%C#/
C*-)=.$## $

Pharmacokinetics : Onset : 5 /
Duration of action : < 10 /
Half-life : 2 /
?. 1. ^. %W$ :
- J  1-5 mcg/kg/min ,$= !
- J, FC 1-4 mcg/kg/min
4
" 10-30 /  AB 20 mcg/kg/min ( ^.=a#$# %W$) ^.=a#//=VW% occlusive vascular disease ,#
 J  1 mcg/kg/min
^C
 $ !! hemodynamic
BF !
- - /F
-
- G 1-3 mcg/kg/min J renal blood flow, urine output
(!  G 1-5 mcg/kg/min)
-
-C  3-10 mcg/kg/min J cardiac output
(!  G 5-15 mcg/kg/min)
-
-. > 10 mcg/kg/min J total peripheral resistance, pulmonary pressure
Maximum dose : 50 mcg/kg/min
*,?!*?!.@A5@B;)5,C45 C4 3.2 mg/mL (3200 mcg) ^.= a#/G - FG
, )
/\ * = J K )%C#/
 FG $   G (hypovolumic shock) A
c # ,# - MC%J G )$  A)
%= J)-
-
 175-280 mcg/ / F % J
-

 $ %J Noradrenaline 5 mcg/ / $ . #
2. -\ :  J  -# : 2-5 mcg/kg/min C )   %/,# - -!/ 
Maximum dose : 20 mcg/kg/min

(67@5,R.43@+. $
34+5 1  Dopamine (2:1) IV 10 mL/hr
#Jr/G
1. Dopamine (2:1) % AB Dopamine ,# 

 %C*  2 mg/mL
2. Dopamine // M  ! C=>
- 200 mg/10 mL
3. C* FG /C$ #
   = J 100 mL *   ^
4. G Dopamine 10 mL ^  FG /C* 100 mL  )-,# 

 2 mg/mL  
5. Rate / % ,* 10 mL/hr $ ! 0.167 mL/min
  1 mL = 60 microdrop
A 0.167 mL  $ ! 0.167x60 = 10 microdrop/min
 "=  Dopamine 10 mL ^  FG 100 mL C# % %C-C*--G -# 10 microdrop $ /

34+5 2  DOPAMINE PREMIXED 2:1 IV 10 mL/hr

#Jr/G
1. Dopamine (2:1) % AB Dopamine ,# 

 %C*  2 mg/mL
2.   % 10 ml/hr % AB  %^.=a#)- ! 2 x 10 = 20 mg/hr
3.   DOPAMINE PREMIXED 400 mg/250 ml = 1.6 mg/ml
5
4. A   20 mg   % rate 20/1.6 = 12.5 ml
 "=  DOPAMINE PREMIXED 400 MG/250 ML  %C-C*--G -# 12.5 JCCJCJ $#M

34+5 3  dopamine (1:1) 2 mcg/kg/min M-/ FG %  #
^.=a# 50 .   % rate $ )
#Jr/G
1.  dopamine 1:1 % ,# #$  C C  1ml / dopamine 1mg (1000mcg)
2. ^.=a#%  50 .  )- ! 100 mcg/min % *$ ! 0.1 ml / min
3. 1ml = 60 microdrop - F 0.1 ml = 6 microdrop
- F  ! C ! J%  dopamine 1:1 iv rate 6 microdrop/min

S@*@T;9
9-;
1. A % %C-C*--G * -# D5W, D5NSS, D5RL , NSS, Mannitol
2. C  #  C C /=> -$  B% ^ alkali solution $ Sodium bicarbonate (NaHCO3)

?!4*A)@TU9

1. ! J%   %C-C*--G M-  infusion pump * %  A,#!,"  )--/

2.  J %$  l C = !J ,# G => M-  J- -. ! 
^.=a# $ ,# -
MC%J C cardiovascular parameters * l (heart rate/rhythm, cardiac index, urine output)
3.  %"- ,$l = !C-C % %"-  /*=m c # ,# - C*- G
4. ! J%  I   C*--
- %W$$ F

*53?45
1. *^  C C  - l  , #/"K%c.J% (25 oC) % * .\ (4 oC) )- 24 #M
2.  C C /=C/ / * A.UJ)-U% *   C#%  

,
V9

1. \! c    C "K%c.J%
2. %   A //=C/ => / FG C% *  

4
*+65@57
,C* )  / %#   )$=> %# =#-, %   %#    =#-Q/ + ,# - MC%J .
% * G ) # I/!C ,# - MC%J . "   %#   ^J-%# C ) # I/!C
6

,WX5
1. #-. vital sign M-#-,# - MC%J C pulse " 2 /* J % C #-" 5 /*,# 
- MC%J .$ -!,//  (=  K 80-100 mmHg systolic) %C  F % J- " 5 /
2. #-. IV site #$ / extravasation % *)$   J- tissue necrosis )- A / # 
 /*!J^J-= J
3.   !*/  ^J-= J $ %#    \#C ^J-%# = J K=V #  C
,# - MC%J C-C C+K /^J#U/-\ => 

4
,*C4!9,
-.?.
Antidote Supportive care )$/ specific antidote

*),)C4.5()ZU;69
1. /,# !
* (sound - alike) ,C ! Dobutamine
2. ,# !  ,G #K
-  ,G #K  \#
 %  ,# 



 C C / %
3. # %C-C*- (Extravasation)

(
!?ZU;
1. ,# CJ  =>  $# C  => mg C !"= J K FG /   * %)-,#


 /  A. 
2. c  calculation sheet  ,G #K*# !
- /^.=a#)- ! %.$ $# +
C )$J maximum dose
3.  * / /*,C  ,# \! %%$   *=m  %J! ^J-
4. ! J%  ^$  C*-
- %W$ *=m  J- extravasation  *  Dopamine /,"K! J
=> vesicant ,# / -.C G % $/ % $  C-J #$ / )%C
 )--/

Medication Safety Issue

#!* % ", F$ $  C ! J%  %C/C/ ,G $  *

References:
Drug Information handbook. 17th edition page 539-541
Intraveneous medication 2004 page 398-402
AFHS 2003 page 1231-1235
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