Dopamine Disease Interactions

The use of dopamine is contraindicated in patients with uncorrected tachyarrhythmias or ventricular fibrillation. Dopamine exerts an agonistic action on the beta receptors of the heart which may lead to an increase in heart rate, atrial fibrillation, enhanced A-V conduction, ventricular ectopy, and arrhythmias.

Dopamine injection contains sodium metabisulfite, a sulfite that may cause anaphylactic symptoms and life-threatening or less severe asthmatic episodes in susceptible people, such as asthmatic patients.

The use of dopamine has been infrequently associated with significant hypotension especially in dehydrated patients secondary to beta-2 mediated vasodilation. Hypovolemia should be corrected before administering dopamine. Blood pressure and ECG should be monitored at regular intervals. Monitoring of cardiac output and pulmonary wedge pressure is recommended.

The use of dopamine may worsen ischemic heart disease. The stimulation of cardiac beta receptors may aggravate ischemic heart disease. Therapy with dopamine should be administered cautiously in patients with ischemic heart disease. Monitoring of ECG, blood pressure, urine flow, and cardiac output is recommended.

The vasoconstrictive actions of dopamine may aggravate occlusive vascular disease (atherosclerosis, arterial embolism, Raynaud's disease, cold injury, diabetic endarteritis, or Buerger's disease). Therapy with dopamine should be administered cautiously in patients with occlusive vascular disease. Patients should be monitored for decreased circulation to the extremities (change in color or temperature of the skin).

The use of dopamine is contraindicated in patients with pheochromocytoma. The catecholamine effects of dopamine may aggravate this condition.