Dopamina
Dopamine
3-hydroxytyramine hydrochloride
También conocido como: Intropin · ASL-279 · dopamini hydrochloridum · 3-hydroxytyramine hydrochloride
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Es una dosis de infusión continua (CRI) basada en la velocidad. Calcule la velocidad de infusión; no aplique un simple ajuste por peso.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Vasodilatory shock if fluid resuscitation and dobutamine is not successful | 2.5-10 micrograms/kg/min | IV | CRI | Titrated to effect | 🌎 NA |
| Adjunctive therapy for acute heart failure | 1-10 micrograms/kg/min | IV | CRI | Titrated to effect | 🌎 NA |
| Treatment of severe hypotension/shock | 1-3 micrograms/kg/minute CRI; higher dosages of 3-10 micrograms/kg/min CRI are indicated if greater cardiotonic and BP support are indicated | IV | CRI | Titrated to effect | 🌎 NA |
| Treatment of severe hypotension/shock after fluid correction and if dobutamine does not give desired effect | 1-10 micrograms/kg/min | IV | CRI | Titrated to effect | 🌎 NA |
| Adjunctive therapy for oliguric renal failure | 1-3 micrograms/kg/min | IV | CRI | Until nonoliguric state achieved | 🌎 NA |
- Vasodilatory shock if fluid resuscitation and dobutamine is not successful: If not successful may try adding norepinephrine.
- Adjunctive therapy for acute heart failure: Initially, a dose of 2 micrograms/kg/min is usually used and titrated upward to desired clinical effect. Doses higher than 10 may increase peripheral vascular resistance and heart rate.
- Treatment of severe hypotension/shock: Not a substitute for adequate volume replacement therapy.
- Adjunctive therapy for oliguric renal failure: Used with diuretics (furosemide). Note: Many now believe that dopamine is not indicated for treating acute renal failure.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Vasodilatory shock if fluid resuscitation and dobutamine is not successful | 2.5-10 micrograms/kg/min | IV | CRI | Titrated to effect | 🌎 NA |
| Treatment of severe hypotension/shock | 1-3 micrograms/kg/minute CRI; higher dosages of 3-10 micrograms/kg/min CRI are indicated if greater cardiotonic and BP support are indicated | IV | CRI | Titrated to effect | 🌎 NA |
| Treatment of severe hypotension/shock after fluid correction and if dobutamine does not give desired effect | 1-10 micrograms/kg/min | IV | CRI | Titrated to effect | 🌎 NA |
- Vasodilatory shock if fluid resuscitation and dobutamine is not successful: If not successful may try adding norepinephrine.
- Treatment of severe hypotension/shock: Not a substitute for adequate volume replacement therapy.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La dopamina es una catecolamina endógena y el precursor metabólico inmediato de la norepinefrina. En medicina veterinaria de cuidados críticos, se utiliza principalmente como una infusión de velocidad constante (CRI) para controlar la inestabilidad hemodinámica, particularmente el shock hipotensivo y la insuficiencia cardíaca aguda, después de una reanimación adecuada con fluidos.
Aspectos clínicos destacados
- Efectos dependientes de la dosis: La afinidad de la dopamina por los receptores cambia drásticamente según la velocidad de infusión, progresando desde efectos dopaminérgicos (vasodilatación) a beta-1 (inotrópicos) y a alfa-1 (vasopresores).
- Controversia sobre la dosis renal: Históricamente, se utilizaba dopamina a "dosis bajas" para promover la diuresis en la lesión renal aguda oligúrica. La evidencia moderna sugiere que no mejora significativamente la Tasa de Filtración Glomerular (TFG) y se considera en gran medida no probada o controvertida en perros, y potencialmente perjudicial en gatos.
- Reglas estrictas de administración: Debe administrarse a través de una vía IV dedicada con una bomba de jeringa o bomba de infusión. La extravasación causa necrosis tisular grave.
Perla clínica: La dopamina es ineficaz y potencialmente peligrosa si se administra a un paciente hipovolémico. Restaure siempre el volumen intravascular antes de iniciar la terapia vasopresora o inotrópica.
Mecanismo de acción
Dopamine acts directly on dopaminergic, β1-adrenergic, and α1-adrenergic receptors, and indirectly by stimulating the release of endogenous norepinephrine from sympathetic nerve terminals. Its effects are highly dose-dependent:
- Low Dose (0.5–2 µg/kg/min): Primarily stimulates D1 and D2 dopaminergic receptors → vasodilation of renal, mesenteric, coronary, and intracerebral vascular beds. Increases renal blood flow and urine output, but does not appreciably increase GFR.
- Medium Dose (2–10 µg/kg/min): Stimulates β1-adrenergic receptors in the myocardium → increases intracellular cAMP → positive inotropic (increased contractility) and mild chronotropic (increased heart rate) effects. Improves cardiac output and organ perfusion.
- High Dose (>10–12 µg/kg/min): Overrides dopaminergic effects and strongly stimulates α1-adrenergic receptors in the vasculature → profound vasoconstriction → increases systemic vascular resistance (SVR) and blood pressure. Renal and peripheral blood flows are decreased at these rates.
Seguridad y advertencias
Contraindicaciones
- Pheochromocytoma
- Ventricular fibrillation
- Uncorrected tachyarrhythmias
- Uncorrected hypovolemia (must replace fluids first)
Efectos adversos
- Nausea and vomiting
- Ectopic beats (arrhythmias)
- Tachycardia
- Palpitations
- Hypotension (at low doses) or Hypertension (at high doses)
- Dyspnea
- Vasoconstriction (reduced peripheral circulation)
- Severe tissue necrosis and sloughing (if extravasated)
Precauciones
Critical Warnings
- Extravasation Risk: Extravasation can cause severe ischemic tissue necrosis and sloughing. Monitor IV sites continuously. If extravasation occurs, infiltrate the ischemic area with 5-10 mg phentolamine diluted in 10-15 mL of normal saline using a fine needle with multiple subcutaneous injections.
- Hypovolemia: Dopamine is not a substitute for adequate fluid, electrolyte, or blood product replacement. Volume deficits must be corrected prior to use.
- Cardiovascular Disease: Use with extreme caution in patients with ischemic heart disease or occlusive vascular disease. Discontinue or reduce dose if arrhythmias (e.g., PVCs) occur or if signs of reduced peripheral circulation develop.
- Feline Renal Failure: Cats are unlikely to benefit from low-dose dopamine for oliguric renal failure, and it may be detrimental.
Interacciones farmacológicas
May antagonize the vasoconstrictive properties of high-dose dopamine.
May result in increased incidences of ventricular arrhythmias.
May potentiate adverse cardiovascular effects.
May antagonize the cardiac (inotropic/chronotropic) effects of dopamine.
May potentiate urine production effects of low-dose dopamine.
Can significantly prolong and enhance the effects of dopamine.
May cause severe hypertension when used concurrently.
May antagonize the renal and mesenteric vasodilatation effects of dopamine.
Concurrent use may cause severe hypertension.
Monitorización
- Continuous electrocardiogram (ECG) for cardiac rate and rhythm
- Direct or indirect blood pressure
- Urine output/flow
- IV catheter site (frequent checks for patency and signs of extravasation)
Farmacocinética
Vida media
Absorción
Not administered orally as it is rapidly metabolized in the GI tract. After IV administration, onset of action is usually within 5 minutes.
Distribución
Widely distributed in the body, but does not cross the blood-brain barrier in appreciable quantities. Placental transfer is unknown.
Metabolismo
Metabolized in the kidney, liver, and plasma by monoamine oxidase (MAO) and catechol-O-methyltransferase (COMT) to inactive compounds. Up to 25% is metabolized to norepinephrine in adrenergic nerve terminals.
Eliminación
Rapidly cleared; effects persist for less than 10 minutes after the infusion is stopped.
Sobredosis
Accidental overdosage is primarily manifested by excessive blood pressure elevation (severe hypertension) and arrhythmias.
- Treatment: Because dopamine's half-life is extremely short (~2 minutes), treatment usually consists only of temporarily discontinuing the IV infusion or reducing the rate until parameters normalize.
- If the patient's condition fails to stabilize rapidly after discontinuation, the alpha-adrenergic antagonist phentolamine may be administered.
Productos disponibles
Formulaciones
- Concentrated solution for injection (40 mg/mL, 80 mg/mL, 160 mg/mL)
- Premixed injection solution in Dextrose 5% (0.8 mg/mL, 1.6 mg/mL, 3.2 mg/mL)
Etiquetado para humanos
- Dopamine HCl for Concentrated Solution for Injection: 40 mg/mL, 80 mg/mL and 160 mg/mL in 5 mL & 10 mL vials
- Dopamine HCl in Dextrose 5% Injection Solution: 200 mg/250 mL (0.8 mg/mL); 400 mg/500 mL (0.8 mg/mL); 400 mg/250 mL (1.6 mg/mL); 800 mg/500 mL (1.6 mg/mL); & 800 mg/250 mL (3.2 mg/mL) in premixed containers
Estado regulador
Sin datos reguladores para: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Protect from light. Store at room temperature (15-30°C). Solutions that are pink, yellow, brown, or purple indicate decomposition and must be discarded. After dilution in compatible IV fluids (e.g., normal saline, D5W, LRS), it is stable for at least 24 hours at room temperature, though it is recommended to dilute just prior to use. Most stable at pH < 5; oxidized at alkaline pH.
Información para el cliente
La dopamina es un medicamento de cuidados críticos utilizado exclusivamente en un entorno hospitalario, generalmente en una Unidad de Cuidados Intensivos (UCI).
- Propósito: Se utiliza para mantener la presión arterial, la función cardíaca y el flujo sanguíneo a los órganos de su mascota durante condiciones potencialmente mortales como shock grave o insuficiencia cardíaca.
- Administración: Se administra como un goteo intravenoso (IV) continuo utilizando una bomba especializada para garantizar una dosificación exacta.
- Monitoreo: Mientras reciba este medicamento, su mascota será monitoreada de cerca por el equipo veterinario, incluyendo controles continuos de frecuencia cardíaca, ECG y presión arterial.
- Seguridad: El equipo veterinario revisará frecuentemente el catéter IV, ya que este medicamento puede causar daño tisular si se filtra fuera de la vena.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.