Expiration date: 07/2026
Composition
Active substance: dopamine hydrochloride 40 mg
Auxiliary substances: sodium metabisulfite, hydrochloric acid 0.1 M solution, water for injections up to 1 l
Packaging
10 ampoules of 5 ml.
Pharmacological action
Cardiotonic, hypotensive, vasodilator, diuretic. Stimulates beta-adrenergic receptors (small doses) and alpha-adrenoreceptors (in large doses). Improvement of systemic hemodynamics leads to a diuretic effect. Has a specific stimulating effect on the postsynaptic dopamine receptors in the smooth muscles of blood vessels and the kidneys. In low doses (0.5-3 mcg/kg/min) acts mainly on dopamine receptors, thereby dilating the renal, mesenteric, coronary and cerebral vessels. Expansion of blood vessels of kidney leads to increased renal blood flow, increased glomerular filtration rate, increase urine output and excretion of sodium, there is also the extension of the mesenteric vessels (the action of dopamine on renal and mesenteric blood vessels differs from the action of catecholamines etc.). In low and medium doses (2-10 mcg/kg/min) stimulates postsynaptic beta1-adrenergic receptors, which causes positive inotropic effect and the increase in minute volume of blood (IOC). Systolic blood pressure (BP) and pulse pressure may increase, while diastolic blood pressure does not change or slightly increases. Total peripheral vascular resistance (SVR) are typically not changed. Coronary blood flow and oxygen consumption of the myocardium, as a rule, increase. In high doses (10 mcg/kg/min or more) is dominated by stimulation of alpha1-adrenergic receptors causing a rise in SVR, heart rate (HR) and renal vasoconstriction (the latter can reduce informed increased renal blood flow and urine output). By increasing the IOC and peripheral vascular resistance increases both systolic and diastolic blood pressure. The beginning of therapeutic effect within 5 minutes on the background I/V administration and lasts for 10 min.
Testimony
Shock different Genesis (cardiogenic shock, postoperative, hypovolemic and infectious – toxic, anaphylactic shock, hypovolemic (only after the restoration of circulating blood volume), acute cardiovascular failure, the syndrome of "low cardiac output" cardiac surgery, hypertension.
Contraindications
Hypersensitivity to the drug (such as other sympathomimetics), idiopathic hypertrophic subaortic stenosis, thyrotoxicosis, feohromotsytoma, zakratougolnaya glaucoma, benign prostatic hyperplasia with clinical manifestations, tachyarrhythmia, ventricular fibrillation. Should not be prescribed for arrhythmias in combination with inhibitors of monoamine oxidase with cyclopropane and halogenated funds for anaesthesia.
Application of pregnancy and breastfeeding
During pregnancy, the drug should be used only if benefit to the mother outweighs the potential risk to the fetus.
Method of application and doses
In/in the drip. Dose set individually, depending on the severity of the shock and the patient's response to treatment. To enhance diuresis and receiving inotropic effect (increase of myocardial activity) is administered with a speed of 100 – 250 mcg/min (1.5-to 3.5 µg/kg/min) (low doses). Under intense surgical treatment is of 300-700 µg/min (4-10 µg/kg/min) (area of medium doses), while septic shock is 750-1500 µg/min (10,5-21 µg/kg/min) (area of maximum doses). With the purpose of influencing the AD recommended increasing the dose to 500 mcg/min or more, or with a constant dose of dopamine additionally appointed norepinephrine (noradrenaline) in the dose 5 mcg/min if patient weight of about 70 kg With the appearance of cardiac arrhythmias, regardless of the applied doses, further dose increase is contraindicated. Babies are administered at a dose of 4 to 6 (maximum 10) µg/kg/min In contrast to adults, in children, the dose should be increased gradually, i.e. starting with the smallest dose. The rate of administration should be individualized to achieve optimal patient response. Most patients are able to maintain a satisfactory condition in the application of doses of dopamine less than 20 mcg/kg/min Duration of use: duration of infusion depends on the individual patient. There is a positive experience infusion for up to 28 days. After stabilization of the clinical situation the abolition of the drug produced gradually.
Special instructions
With increased pre - and afterload on the myocardium for unloading of the heart to a combination of nitroglycerin or nitroprusside sodium.
Drug interactions
While the appointment of dopamine and guanetidina enhanced sympathomimetic effects. Patients who are treated with monoamine oxidase inhibitors, need much lower doses of dopamine (up to about 1/10 the normal dose). Simultaneous use of dopamine and diuretics can lead to summing and potentiating effect. Also known interaction between dopamine and tricyclic antidepressants, and painkillers (increased propensity for cardiac arrhythmias) and phenytoin (decrease in blood pressure and bradycardia). In combination with ergot alkaloids dopamine can lead to maximum contraction of the peripheral vessels, which creates the danger of gangrene.
Storage conditions
In a dry, protected from light place at temperature not exceeding 25 °C. of the reach of children.
Shelf life
3 years.
