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Description of the medicine: Dopamine (Dophaminum, Dofaminum)

DOPAMINE (Dophaminum, Dofaminum). 2- (3,4-Dioxyphenyl) -ethylamine, or oxytiramine.

Synonyms: Dopamine, Dopamine, Aprical, Cardiosteril, Dopamex, Dopamin, Dophan, Dopmin, Dynatra, Hydroxytyramin, Intropin, Revivan.

For use as a medicine, dopamine is produced synthetically.

According to the chemical structure, dopamine is a catecholamine and has a number of pharmacological properties characteristic of adrenergic substances. It has a specific effect on dopamine receptors, for which it is an endogenous ligand, but in large doses it also stimulates α- and β-adrenergic receptors. The effect on adrenoreceptors is related to the ability of dopamine to release noradrenaline from granular (presynaptic) depots, i.e. To have an indirect adrenomimetic effect.

Under the influence of dopamine, there is an increase in peripheral vascular resistance (less severe than under norepinephrine) and an increase in systolic blood pressure (the result of α-adrenergic receptor stimulation), cardiac contractions (the result of β-adrenergic receptor stimulation), and cardiac output increase. The heart rate changes relatively little. The need for myocardium in oxygen increases, but as a result of increased coronary blood flow, increased oxygen delivery is provided.

As a result of specific binding to dopamine receptors of kidneys, dopamine reduces the resistance of renal vessels, increases blood flow and renal filtration in them. Along with this, natriuresis also increases, and mesenteric vessels also expand. This effect on the renal and mesenteric vessels of dopamine differs from other catecholamines (noradrenaline, adrenaline, etc.). In large, however, doses (when administered to people at doses exceeding 15 mcg / kg per minute), dopamine may cause narrowing of the kidney vessels.

Dopamine also inhibits the synthesis of aldosterone.

Pharmacological effects of dopamine are manifested with its intravenous administration; When injected into the stomach, it is poorly absorbed. Due to the fact that it rapidly decomposes, the main method of its application is slow drop infusion.

Through the blood-brain barrier, dopamine does not penetrate and, when injected into a vein, does not affect the central nervous system (see Tools for the Treatment of Parkinsonism).

Indications for the use of dopamine are shock states of various etiologies: cardiogenic, traumatic, endotoxic, postoperative, hypovolemic shock, etc. Due to less influence on peripheral vascular resistance, increased renal blood flow and blood flow in other internal organs, less chronotropic effect and other features of dopamine In these cases, are more indicated than norepinephrine and other catecholamines.