dopamine drips and MAP

[confuzzled]

When you have a patient and you are adjusting the dopamine drip based on MAP > 65 do you just guess how much to increase or decrease?

[getoverit, BSN, RN, EMT-P]

start increasing by 1 mcg/kg/m. If the pressure doesn't respond then you could go up by 2.

some people are so affected by dopamine, i've seen patients who had a map>65 with 6.3mcg/kg/m and when you dropped them to 6.0 their maps fell into the 40-50 range.

very narrow therapeutic range for some patients.

[confuzzled]

Thank you! That makes sense to go slow but no where could I find a guideline

[meandragonbrett]

Do you guys have Lexicomp access? They have good information in their drug guides. Typically the hospital will have a policy on "Adult Titration of Vasoactive Infusions" or something similar that will review all the vasoactive meds and how to titrate them according to hospital policy.

[confuzzled]

Actually Im a senior nursing student and was inquiring for a clinical experience, but I will ask when I go the next time. Thank you

[canusnurse]

also realize that with Dopamine, when you have a drip over 6mcg/kg/min, it will begin to increase the heartrate exponentially

[confuzzled]

This is off topic but what is the best way to utilize this website?

[canusnurse]

there is a section for nursing students, and then you can also browse subjects of interest, like critical care, etc. Hope this helps?

[confuzzled]

Yes all of you have been very helpful :)