Dopamine is a potent drug that must administered at a closely calculated drip rate. It is usually given by a registered nurse or physician in the emergency room or intensive care unit. It is used to treat a patient that has gone into shock after a heart attack, septicemia, open heart surgery, kidney failure or when the heart does not have sufficient pumping force to keep the blood pressure at normal levels.
Step 1
Determine the amount ordered. A typical doctor's order may vary from 2 to 50 micrograms (mcg) per kilogram (kg) per minute, depending on the patient's condition and the desired effect. As an example, we will use a doctor's order of 5 mcg/kg/minute.
Step 2
Find out how much the patient weighs in kilos. There are 2.2 lbs. in a kilo; so, to find the number of kilos your patient weighs, divide the weight in pounds by 2.2.
For example, if your patient weighs 120 lbs. you would calculate: 120 / 2.2= 54.5, we can round this number up to 55 kilos.
Step 3
Determine the dose you have available. Dopamine comes in vials of 40mg/ml, 80mg/ml or 160mg/ml. For our example, we will use a vial of 160mg/ml.
Step 4
Choose the volume you will use. Dopamine is concentrated and must be diluted. To do this, inject the contents of the dopamine vial in 250 ml or 500 ml of one of the following: Sodium Chloride Injection (NS), dextrose 5 percent (D5W), Lactated Ringer's Injection (LR) or a solution the doctor has ordered. For our example, we will use 250 ml of D5W.
Step 5
Calculate the dosage. Multiply the ordered dose in micrograms by the patient weight in kilograms; divide the result by 1,000, then multiply it by 60. This will give you the dosage in milligrams per hour.
((ordered dose x patient weight) / 1,000) x 60 = dosage in mg/hr
(5 mcg x 55 kg) / 1,000 x 60 = 16.5 mg/hr
Example: 5 mg x 55 kg = 275
275 / 1,000 = 0.275
0.275 x 60 = 16.5 mg/hr
The ordered dose is 16.5 milligrams per hour.
Step 6
Calculate the flow rate. Divide the ordered dose, in mg/hr, by the available dose, in mg. Multiply the result by the available volume, in ml, to get ml/hr.
(ordered dose / available dose) x volume = flow rate
(16.5 mg/hr / 160 mg) x 250 ml = 25.8 ml/hr
Example: 16.5 / 160 = 0.103
0.103 x 250 = 25.8 ml/hr
To infuse the ordered 5 mcg/kg/min, set the flow rate at 26 ml/hr.
Tips and Warnings
- Use dimensional analysis to create formulas. Dilute just before using as solution is only stable for 24 hours. IV pump is essential for good rate of flow control. Monitor blood pressure closely. Watch for infiltration. Keep solution away from light. Monitor urine output closely.
- Check your math results carefully. Watch for side effects, such as increased heart rate, arrhythmias and tissue necrosis at IV site. Do not stop giving drug suddenly as it may lead to blood pressure decrease. It may cause severe tissue necrosis with infiltration. Dopamine is incompatible with alkaline solutions.
Things You'll Need
- Medication vial
- Alcohol wipes
- Syringe
- IV solution bag
- IV tubing
- IV pump
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