Dopamine (Medication)

Dopamine

Skeletal formula of dopamine
Ball-and-stick model of the zwitterionic form of dopamine found in the crystal structure[1]
Clinical data
Trade names	Intropin, Dopastat, Revimine, others
Other names	2-(3,4-Dihydroxyphenyl)ethylamine; 3,4-Dihydroxyphenethylamine; 3-hydroxytyramine; DA; Intropin; Revivan; Oxytyramine; Prolactin inhibiting factor; Prolactin inhibiting hormone
AHFS/Drugs.com	Monograph
License data	US FDA: Dopamine
Pregnancy category	US: C (Risk not ruled out)
Routes of administration	Intravenous injection
ATC code	C01CA04 (WHO)
Physiology data
Source tissues	Substantia nigra; ventral tegmental area; many others
Target tissues	System-wide
Receptors	D1, D2, D3, D4, D5, TAAR1[2]
Agonists	Direct: apomorphine, bromocriptine Indirect: cocaine, amphetamine
Antagonists	Neuroleptics, metoclopramide, domperidone
Metabolism	MAO, COMT,[2] ALDH, DBH, MAO-A, MAO-B, COMT
Legal status
Legal status	In general: ℞ (Prescription only)
Pharmacokinetic data
Metabolism	MAO, COMT,[2] ALDH, DBH, MAO-A, MAO-B, COMT
Excretion	Kidney
Identifiers
IUPAC name 4-(2-Aminoethyl)benzene-1,2-diol
CAS Number	51-61-6 Y 62-31-7 (hydrochloride)
PubChem CID	681
IUPHAR/BPS	940
DrugBank	DB00988 Y
ChemSpider	661 Y
UNII	VTD58H1Z2X
KEGG	D07870 Y
ChEBI	CHEBI:18243 Y
ChEMBL	ChEMBL59 Y
Chemical and physical data
Formula	C8H11NO2
Molar mass	153.181 g·mol−1
3D model (JSmol)	Interactive image
Density	1.26 g/cm3
Melting point	128 °C (262 °F)
Boiling point	decomposes
SMILES c1cc(c(cc1CCN)O)O
InChI InChI=1S/C8H11NO2/c9-4-3-6-1-2-7(10)8(11)5-6/h1-2,5,10-11H,3-4,9H2 Y Key:VYFYYTLLBUKUHU-UHFFFAOYSA-N Y
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Dopamine, sold under the brandname Intropin among others, is a medication most commonly used in the treatment of very low blood pressure, a slow heart rate that is causing symptoms, and, if epinephrine is not available, cardiac arrest.^[3] In newborn babies it continues to be the preferred treatment for very low blood pressure.^[4] In children epinephrine or norepinephrine is generally preferred while in adults norepinephrine is generally preferred for very low blood pressure.^[5][6] It is given intravenously or intraosseously as a continuous infusion.^[3] Effects typically begin within five minutes.^[3] Doses are then increased to effect.^[3]

Common side effects include worsening kidney function, an irregular heartbeat, chest pain, vomiting, headache, or anxiety.^[3] If it enters into the soft tissue around the vein local tissue death may occur.^[3] The medication phentolamine can be given to try to decrease this risk.^[3] It is unclear if dopamine is safe to use during pregnancy or breastfeeding.^[3] At low doses dopamine mainly triggers dopamine receptors and β1-adrenergic receptors while at high doses it works via α-adrenergic receptors.^[3]

Dopamine was first synthesized in a laboratory in 1910 by George Barger and James Ewens in England.^[7] It is on the World Health Organization's List of Essential Medicines.^[8] In human physiology dopamine is a neurotransmitter as well as a hormone.^[9]

In newborn babies it continues to be the preferred treatment for very low blood pressure.^[4] In children epinephrine or norepinephrine is generally preferred while in adults norepinephrine is generally preferred for very low blood pressure.^[5][6]

In those with low blood volume or septic shock, this should be corrected with intravenous fluids before dopamine is considered.^[3]

Low-dosage dopamine has been routinely used for the treatment and prevention of acute kidney injury. However, since 1999 a number of reviews have concluded that doses at such low levels are not effective and may sometimes be harmful.^[10][11]

Since the half-life of dopamine in plasma is short—approximately one minute in adults, two minutes in newborn babies and up to five minutes in preterm babies—it is usually given as a continuous intravenous drip rather than a single injection.^[12]

A fluorinated form of L-DOPA known as fluorodopa is available for use in positron emission tomography to assess the function of the nigrostriatal pathway.^[13]

Dopamine should generally not be given to people who have a pheochromocytoma or uncorrected very fast heart rate.^[3]

The LD₅₀, or dose which is expected to prove lethal in 50% of the population, has been found to be: 59 mg/kg (mouse; administered intravenously); 950 mg/kg (mouse; administered intraperitoneally); 163 mg/kg (rat; administered intraperitoneally); 79 mg/kg (dog; administered intravenously).^[14]

If extravasation occurs local tissue death may result.^[3] The medication phentolamine can be injected at the site to try to decrease the risk of tissue death.^[3]

Its effects, depending on dosage, include an increase in sodium excretion by the kidneys, an increase in urine output, an increase in heart rate, and an increase in blood pressure.^[12] At low doses it acts through the sympathetic nervous system to increase heart muscle contraction force and heart rate, thereby increasing cardiac output and blood pressure.^[15] Higher doses also cause vasoconstriction that further increases blood pressure.^[15][16]

While some effects result from stimulation of dopamine receptors, the prominent cardiovascular effects result from dopamine acting at α₁, β₁, and β₂ adrenergic receptors.^[17][18]

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