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Dopamine in the ED
- Recall that dopamine is an endogenous catecholamine that is a precursor for norepinephrine synthesis
- Despite the popularity of norepinephrine, dopamine is still used by many EPs in the setting of septic shock
- Dopamine produces progressive alpha-receptor stimulation at doses > 10 mcg/kg/min
- Tachyarrhythmias (namely sinus tachycardia) is the predominant adverse effect
- When selecting a vasopressor agent, be sure to check the HR. If the patient is already tachycardic, the addition of dopamine will only worsen the tachycardia
- Additional important adverse effects are increased intraocular pressure and delayed gastric emptying
References
Marino PL. Hemodynamic drugs. In: The Little ICU Book of Facts and Formulas. 2009 Ed. Lippincott Williams & Wilkins, Philadelphia, PA.