Looking at the dosage and usage of dopamine, do you dare to push it at will?

A few days ago, I visited the outpatient clinic once a week for painless examinations and found something incredible: I don't know when the doctors who went to the outpatient clinic for painless gastroscopy started using dopamine to raise blood pressure

In order to clarify the situation, I asked him to find out the situation that afternoon

However, Dr.

When I asked him why he chose dopamine, he told me: Dopamine can raise blood pressure, and there is no need to prescribe it, which is convenient to use

It is important to improve the skills of young physicians, but it is more important to let them know the risks

I still have a lot of experience in improving the safety awareness of physicians in the department: If you want them to know the risks and value them, let them learn more

So, I called Dr.

First of all, we need to clarify what kind of drug dopamine is?

Dopamine is an a, β adrenergic receptor agonist, which mainly acts by stimulating the sympathetic nervous system adrenergic receptors (a and β1) and dopamine receptors located in the kidney, mesenteric, coronary and cerebral arteries

Its heart blood vessels effect, mainly used for clinical treatment of a variety of shock

Because dopamine can act on α receptors and β1 receptors as well as dopamine receptors on peripheral target cells

Pharmacological action

1) A medium dose (5-10 micrograms/kg/min) stimulates cardiac β1 receptors to strengthen myocardial contractility and increase heart rate;

2) Large doses (>10 micrograms/kg/min) act on the a receptors of blood vessels to increase systolic blood pressure and pulse pressure;

3) Small doses (2-5 micrograms/kg/min) stimulate renal dopamine receptors, make renal vasodilation, renal blood flow and glomerular filtration rate increase; inhibit renal tubular reabsorption of sodium, excretion of sodium and diuresis

Due to the pharmacological properties of dopamine, when large doses are used, especially after large doses are used for a long time, sudden withdrawal of the drug will cause a sharp drop in blood pressure

When I got these knowledge points out, he said: I dare not push it easily in the future

1.
Liang Xingtian, Liao Meijuan, Li Weimin, et al.
Effects of different doses of dopamine on hemodynamics in patients undergoing bronchoscopy with remifentanil combined with propofol[J].
Guangdong Medicine, 2016, 37(011):1699 -1701.

2.
Shen Xian , Zou Yunsu, Zhao Li, et al.
The efficacy of different starting doses of dopamine in the treatment of hypotension in preterm infants[J].
Chinese Journal of Practical Pediatrics, 2013.

3.
Liu Zhenghe.
A case review of the rescue of cardiac arrest with different doses of dopamine combined with adrenaline[J].
Journal of Medical Forum, 2015, 036(006):117-118.