Editing Dopamine (section)

==Medical uses==
{{Main|Dopamine (medication)}}
[[File:Dopamine HCl.JPG|thumb|upright=0.75|Dopamine HCl preparation, single dose vial for intravenous administration|alt=Dopamine HCl preparation, single dose vial for intravenous administration.]]

Dopamine as a manufactured [[pharmaceutical drug|medication]] is sold under the trade names Intropin, Dopastat, and Revimine, among others. It is on the [[World Health Organization's List of Essential Medicines]].<ref>{{cite web|title=WHO Model List of Essential Medicines| url=http://apps.who.int/iris/bitstream/10665/93142/1/EML_18_eng.pdf |archive-url=https://web.archive.org/web/20140210093816/http://apps.who.int/iris/bitstream/10665/93142/1/EML_18_eng.pdf |archive-date=2014-02-10 |url-status=live| website=World Health Organization| access-date=24 September 2015| date=October 2013}}</ref> It is most commonly used as a stimulant drug in the treatment of severe [[hypotension|low blood pressure]], [[bradycardia|slow heart rate]], and [[cardiac arrest]]. It is especially important in treating these in [[neonates|newborn infants]].<ref name=Noori>{{cite journal |vauthors=Noori S, Friedlich P, Seri I |year=2003 |title=Pharmacology Review Developmentally Regulated Cardiovascular, Renal, and Neuroendocrine Effects of Dopamine |journal=NeoReviews |volume=4 |issue=10 |pages=e283–e288 |url=https://www.researchgate.net/publication/239322432 |access-date=24 September 2015 |doi=10.1542/neo.4-10-e283|s2cid=71902752 }}</ref><ref name="medscape2021"/> It is given intravenously. Since the half-life of dopamine in plasma is very short—approximately one minute in adults, two minutes in newborn infants and up to five minutes in preterm infants—it is usually given in a continuous intravenous drip rather than a single injection.<ref name=BhattMehta>{{cite journal | vauthors = Bhatt-Mehta V, Nahata MC | title = Dopamine and dobutamine in pediatric therapy | journal = Pharmacotherapy | volume = 9 | issue = 5 | pages = 303–14 | year = 1989 | pmid = 2682552 | doi = 10.1002/j.1875-9114.1989.tb04142.x | s2cid = 25614283 }}</ref>

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]].<ref name=BhattMehta/> At low doses it acts through the sympathetic nervous system to increase [[stroke volume|heart muscle contraction force]] and heart rate, thereby increasing [[cardiac output]] and blood pressure.<ref name="BryantKnights2010"/> Higher doses also cause [[vasoconstriction]] that further increases blood pressure.<ref name="BryantKnights2010">{{cite book | vauthors = Bronwen JB, Knights KM |title=Pharmacology for Health Professionals |edition=2nd |year=2009 |publisher=Elsevier Australia |isbn=978-0-7295-3929-6 |page=192}}</ref><ref>{{cite journal | vauthors = De Backer D, Biston P, Devriendt J, Madl C, Chochrad D, Aldecoa C, Brasseur A, Defrance P, Gottignies P, Vincent JL | title = Comparison of dopamine and norepinephrine in the treatment of shock | journal = The New England Journal of Medicine | volume = 362 | issue = 9 | pages = 779–89 | date = March 2010 | pmid = 20200382 | doi = 10.1056/NEJMoa0907118 | url = http://pdfs.semanticscholar.org/9c4a/b0084f4be06a36c826a1e598ec6593827c9d.pdf | url-status = dead | s2cid = 2208904 | archive-url = https://web.archive.org/web/20190228043236/http://pdfs.semanticscholar.org/9c4a/b0084f4be06a36c826a1e598ec6593827c9d.pdf | archive-date = 2019-02-28 }}</ref> Older literature also describes very low doses thought to improve kidney function without other consequences, but recent reviews have concluded that doses at such low levels are not effective and may sometimes be harmful.<ref>{{cite journal | vauthors = Karthik S, Lisbon A | title = Low-dose dopamine in the intensive care unit | journal = Seminars in Dialysis | volume = 19 | issue = 6 | pages = 465–71 | year = 2006 | pmid = 17150046 | doi = 10.1111/j.1525-139X.2006.00208.x | s2cid = 22538344 }}</ref> While some effects result from stimulation of dopamine receptors, the prominent cardiovascular effects result from dopamine acting at [[Alpha-1 adrenergic receptor|α<sub>1</sub>]], [[Β1-adrenergic receptor|β<sub>1</sub>]], and [[Β2 receptor|β<sub>2</sub>]] [[adrenergic receptor]]s.<ref>{{Cite web|title = Dopamine|url = http://www.fpnotebook.com/cv/pharm/Dpmn.htm|website = Family Practice Notebook|access-date = 1 February 2016| vauthors = Moses S |quote = <!-- Dopamine binds to alpha-1 and beta-1 adrenergic receptors. Mediated through myocardial beta-1 adrenergic receptors, dopamine increase heart rate and force, thereby increasing cardiac output. Alpha-1 adrenergic receptor stimulation on vascular smooth muscle, leads to vasoconstriction and results in an increase in systemic vascular resistance --> }}</ref><ref>{{cite book | title = Clinical Cardiology: Current Practice Guidelines|url = https://books.google.com/books?id=YytoAgAAQBAJ|publisher = OUP Oxford|year= 2013|isbn = 978-0-19-150851-6 | vauthors = Katritsis DG, Gersh BJ, Camm AJ |quote = Dopamine binds to beta-1, beta-2, alpha-1 and dopaminergic receptors }}</ref>

[[Side effects]] of dopamine include negative effects on kidney function and [[cardiac arrhythmias|irregular heartbeats]].<ref name="BryantKnights2010"/> The [[median lethal dose|LD<sub>50</sub>]], or lethal dose which is expected to prove fatal in 50% of the population, has been found to be: 59&nbsp;mg/kg (mouse; administered [[intravenously]]); 95&nbsp;mg/kg (mouse; administered [[intraperitoneally]]); 163&nbsp;mg/kg (rat; administered intraperitoneally); 79&nbsp;mg/kg (dog; administered intravenously).<ref>{{cite book | vauthors = Lewis RJ | year = 2004 |title=Sax's Dangerous Properties of Industrial Materials |edition=11th |page=1552 |publisher=Wiley & Sons |location=Hoboken, NJ |isbn=978-0-471-47662-7}}</ref>