Vasopressors and inotropes
Dopamine (Intropin) drip
Intropin
Dosing
| Start | 2–5 mcg/kg/min; symptomatic bradycardia 5–20 |
|---|---|
| Titrate | 1–4 mcg/kg/min every 10–30 minutes |
| Maximum | 20 mcg/kg/min usual; label up to 50 |
| Common bags | 400 mg in 250 mL (1.6 mg/mL); 800 mg in 250 mL (3.2 mg/mL) |
| Dose units | mcg/kg/min |
Line and administration
- Central line preferred; peripheral is acceptable short term in a large proximal arm vein with frequent site checks
- Extravasation: stop, aspirate, phentolamine 5–10 mg in 10–15 mL saline injected into the area
Watch for
- More arrhythmias than norepinephrine (not first line in septic shock)
- Low-dose "renal" dopamine does not protect the kidneys
Dopamine: full drug monographIndications, mechanism, pharmacokinetics, cautions and every dose the app lists.
In the one-pagers
- Vasopressors and InotropesReceptors and effects: Dopamine: DA <5, β1 5–10, α1 >10 mcg/kg/min: ↑ / ↑ / ↑ at high dose
- Shock Types at a GlanceCardiogenic shock: LV, RV, SCAI and MCS escalation: Norepinephrine first (SOAP II); avoid dopamine and use epinephrine cautiously (OptimaCC: refractory shock 37% vs 7% with norepinephrine).
- Temporary PacingTranscutaneous pacing (TCP): Dopamine: 5 to 20 mcg/kg/min
- Toxins, Stings and Anaphylaxis in the FieldHidden or delayed drug toxicity: Disulfiram plus alcohol: Flushing, headache, vomiting, shock: Fluids, then norepinephrine (dopamine may fail)
- ACLS Algorithms in BriefBradycardia with a pulse: If atropine fails: transcutaneous pacing and/or dopamine 5–20 mcg/kg/min or epinephrine 2–10 mcg/min
- Pediatric Assessment and EmergenciesShock, fluids and sepsis (Phoenix 2024): For fluid-refractory septic shock start epinephrine or norepinephrine (PALS 2025, 2a), peripherally until central access is in (SSC); dopamine only if neither is available. Stress-dose hydrocortisone may be considered once vasoactives are needed (2b) and is given early for known adrenal insufficiency. Check glucose and ionized calcium.
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Other vasopressors and inotropes
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For education and exam preparation only. Follow your institution’s protocols. Study aid: check every dose against your local protocols and medical direction, the bag label and your pump.