Educational use only. Drug cards are AI-assisted study material for NCLEX preparation.
Mechanism of action
Stimulates dopamine, beta-1, and alpha-1 receptors with effects that are highly dose-dependent: low doses dilate renal and mesenteric vessels (D1), moderate doses increase contractility and heart rate (β1), and high doses cause systemic vasoconstriction (α1) and raise blood pressure. Used for hemodynamic support in cardiogenic shock, septic shock (second-line), and symptomatic bradycardia.
Adverse effects
Life-threatening / NCLEX-tested
- Severe tissue necrosis from extravasation — give through a central line whenever possible
- Tachyarrhythmias and ventricular ectopy
- Severe hypertension at high doses
- Worsening myocardial ischemia from increased oxygen demand
- Mesenteric or peripheral ischemia at high doses (cold/mottled extremities)
- Pulmonary edema in heart failure
Side effects
Common — what to teach
- Headache
- Nausea, vomiting
- Anxiety or restlessness
- Mild palpitations
- Mild peripheral vasoconstriction
Food & drug interactions
MAOIs prolong and intensify dopamine effects — use a fraction of the usual dose (1/10) if unavoidable. Phenytoin can cause severe hypotension when given to patients on dopamine. Tricyclic antidepressants and beta blockers alter response. Sodium bicarbonate inactivates dopamine — never mix in the same line.
Nursing implications
Assessment, monitoring, patient teaching
- Administer through a CENTRAL line whenever possible; if peripheral, use a large proximal vein and watch the site every 15–30 minutes
- If extravasation occurs: stop the infusion, leave the catheter in place, and treat with phentolamine infiltration ASAP
- Continuous ECG and BP monitoring (preferably arterial line for high doses)
- Strict I&O and hourly urine output — perfusion is the goal
- Titrate to target MAP (often ≥ 65 mmHg) per provider; document the dose change with each titration
- Wean slowly when discontinuing — abrupt stop can cause profound hypotension
When to hold / contraindications
- Tachyarrhythmia or new sustained VT
- Pheochromocytoma (catecholamine excess)
- Uncorrected hypovolemia (volume-resuscitate first; pressors are not a replacement for fluid)
- Severe peripheral or mesenteric ischemia
- Recent MAOI use (within 14 days) without dose adjustment
Memory anchor
Dopamine is dose-dependent: "low = renal, mid = beat, high = squeeze." Central line preferred; phentolamine reverses extravasation. Volume before pressors.
Practice Dopamine questions
Test your recall on real NCLEX-style pharmacology questions — with full rationales and an AI Coach for the parts you miss.