Management of  Dopamine Administration

Description

• Clear, colourless solution 40 mg/ml in 5 ml ampoules.
• pH 2.5-4.5 (contains 1% sodium metabisulfite)

Charted on fluid chart giving:

• rate in ml/hour
• dose in micrograms/kg/minute

Also charted on drug chart under continuous infusions giving:

• amount of drug to be added
• base fluid type and volume
• rate in mL/hour and dose in micrograms/kg/minute

Administration

Continuous Infusion

Should be administered via a central line (UVC, Longline, or Surgical CVL).
If no central access available, use a cannula in a large vein.

1. Administered by a nurse with Neonatal IV Drug Certification.
2. Discoloration of solution (yellow, brown, pink, purple) indicates decomposition and should be discarded.
3. Dilute 30 mg/kg (0.75 ml/kg) dopamine to make 50ml with NS or D5W - 1 ml/hour = 10 micrograms/kg/minute.
4. Compatible with sodium chloride 0.9%, glucose 5% and glucose 10%
5. Compatible at Y injection site with dobutamine, morphine, heparin, PGE1.
6. Incompatible with acyclovir, indomethacin, insulin, frusemide,, sodium bicarbonate and other alkaline solutions including phenytoin. No information available on IVN, therefore avoid co-infusion if possible.
7. Do NOT mix with any other drug, blood, or blood products. Do NOT flush line.
8. Administer via a syringe pump.
9. Change fluid and tubing every 48 hours or earlier if solution is discoloured.

Nursing Considerations

1. Monitor for adverse reactions.
2. Observe closely for IV filtration; discontinue immediately and notify doctor/NS-ANP. Avoid extravasation of drug as may cause necrosis and tissue sloughing.
3. Assess colour and temperature of extremities.
4. Continuous blood pressure monitoring. If a disproportionate rise in diastolic pressure (decreased pulse pressure) notify doctor/NS-ANP immediately.
5. Continuous cardiorespiratory monitoring.
6. Document vital signs hourly and PRN.
7. Monitor urinary output.

Storage

• At room temperature <30°C. Protect from light.
• Diluted solution stable for 48 hours at room temperature.

References