도파민
Dopamine
3-hydroxytyramine hydrochloride
다른 이름: Intropin · ASL-279 · dopamini hydrochloridum · 3-hydroxytyramine hydrochloride
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
지속 정주(CRI) 속도 기반 용량입니다. 단순 체중 환산이 아니라 주입 속도를 계산해야 합니다.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
도파민은 내인성 카테콜아민이며 노르에피네프린의 직접적인 대사 전구체입니다. 수의학 중환자 치료에서 주로 적절한 수액 소생술 이후 혈역학적 불안정성(특히 저혈압성 쇼크 및 급성 심부전)을 관리하기 위해 지속적 정맥 주입(CRI)으로 사용됩니다.
임상 요약
- 용량 의존적 효과: 도파민의 수용체 친화력은 주입 속도에 따라 극적으로 변하며, 도파민성(혈관 확장)에서 베타-1(강심 작용), 알파-1(승압 작용) 효과로 진행됩니다.
- 신장 용량 논란: 과거에는 핍뇨성 급성 신손상에서 이뇨를 촉진하기 위해 '저용량' 도파민이 사용되었습니다. 현대의 증거에 따르면 사구체 여과율(GFR)을 유의하게 개선하지 못하며, 개에서의 사용은 입증되지 않았거나 논란의 여지가 있고 고양이에게는 해로울 수 있습니다.
- 엄격한 투여 규칙: 전용 정맥 라인과 주사기 펌프 또는 수액 펌프를 사용하여 투여해야 합니다. 혈관 외 유출은 심각한 조직 괴사를 유발합니다.
작용 기전
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.
안전성·주의사항
금기사항
- Pheochromocytoma
- Ventricular fibrillation
- Uncorrected tachyarrhythmias
- Uncorrected hypovolemia (must replace fluids first)
부작용
- 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)
주의
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.
약물 상호작용
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.
모니터링
- 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)
약동학
반감기
흡수
Not administered orally as it is rapidly metabolized in the GI tract. After IV administration, onset of action is usually within 5 minutes.
분포
Widely distributed in the body, but does not cross the blood-brain barrier in appreciable quantities. Placental transfer is unknown.
대사
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.
배설
Rapidly cleared; effects persist for less than 10 minutes after the infusion is stopped.
과다투여
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.
제품
제형
- 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)
인용의약품
- 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
규제 현황
규제 데이터 없음: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
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.
보호자 정보
도파민은 일반적으로 중환자실(ICU)과 같은 병원 환경에서만 사용되는 중환자 치료 약물입니다.
- 목적: 심각한 쇼크나 심부전과 같이 생명을 위협하는 상황에서 반려동물의 혈압, 심장 기능 및 장기 혈류를 지원하는 데 사용됩니다.
- 투여 방법: 정확한 용량을 보장하기 위해 특수 펌프를 사용하여 지속적인 정맥(IV) 점적 주사로 투여됩니다.
- 모니터링: 이 약물을 투여하는 동안 수의료진은 지속적인 심박수, 심전도 및 혈압 확인을 포함하여 반려동물을 면밀히 모니터링합니다.
- 안전성: 이 약물이 혈관 밖으로 누출될 경우 조직 손상을 일으킬 수 있으므로 수의료진이 정맥 카테터를 자주 확인합니다.
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