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  药店国别: 美国药房
产地国家: 美国
所属类别: 心血管系统药物->心肌梗死
处方药:处方药
包装规格: 200毫克/5毫升 25X5毫升
计价单位:
  点击放大  
生产厂家英文名:
Hospira Worldwide
该药品相关信息网址1:
https://www.rxlist.com/dopamine-drug.htm
原产地英文商品名:
DOPamine Hydrochloride 200mg/5ml 25X5ml
原产地英文药品名:
DOPAMINE HYDROCHLORIDE
中文参考商品译名:
葡萄糖中的多巴胺盐酸盐 200毫克/5毫升 25X5毫升
中文参考药品译名:
多巴胺盐酸盐
原产地国家批准上市年份:
2005/04/30
英文适应病症1:
the correction of hemodynamic imbalances present in shock due to myocardial infarction, trauma, endotoxic septicemia, open heart surgery, renal failure and chronic cardiac decompensation as in refractory congestive failure
临床试验期:
完成
中文适应病症参考翻译1:
矫正由于心肌梗塞,创伤,内毒素性败血症,心脏直视手术,肾功能衰竭和慢性心脏代偿失调而存在的休克中的血液动力学失衡
药品信息:

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详细处方信息以本药内容附件PDF文件(201932017585222.pdf)的“原文Priscribing Information”为准
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部分中文葡萄糖中的多巴胺盐酸盐处方资料(仅供参考)


【英文名称】
Dopamine Hydrochloride in Dextrose

【适用证】

5%葡萄糖注射液中的多巴胺盐酸盐,USP适用于矫正由于心肌梗塞,创伤,内毒素性败血症,心脏直视手术,肾功能衰竭和慢性心脏代偿失调而存在的休克中的血液动力学失衡,如难治性充血性衰竭。

如果需要,在给予多巴胺盐酸盐之前,应使用合适的血浆扩张剂或全血来恢复循环量。

最有可能对多巴胺有反应的患者是那些生理参数(如尿流量,心肌功能和血压)未发生极端恶化的患者。报告表明,症状和症状发作与开始用体积恢复和多巴胺治疗之间的时间越短,预后越好。

生命器官灌注不良:虽然尿流显然是监测重要器官灌注的更好诊断标志之一,但医生也应该观察患者是否有精神错乱或昏迷逆转的迹象。也可以观察到苍白的损失,脚趾温度的增加或甲床毛细血管充盈的充分性作为适当剂量的指标。报告的研究表明,当尿流量减少至约0.3毫升/分钟之前给予多巴胺时,预后更为有利。

然而,已经观察到,在一些少尿或无尿患者中,药物的施用已经产生尿流量的增加,其可以达到正常水平。该药物还可以增加输出在正常范围内的患者的尿流量,因此可以帮助降低预先存在的液体积聚的程度。相反,在给定患者的高于最佳剂量的情况下,尿流量可能减少,需要减少剂量。多巴胺和利尿剂的伴随施用可产生添加剂或增效作用。

心脏输出量低:多巴胺对心肌的直接肌力作用会增加低剂量或中等剂量的心输出量,这与预后良好有关。增加的输出与未改变或降低的全身血管阻力(SVR)相关。静态或降低的SVR与心输出量的低或中度增加的关联被认为是对特定血管床的不同影响的反映,其中外周床(例如,股骨)的阻力增加,并且肠系膜和肾血管床的同时减少。血流的重新分布与这些变化平行,因此心输出量的增加伴随着肠系膜和肾血流的增加。在许多情况下,已发现总心输出量的肾脏分数增加。多巴胺产生的心输出量的增加与异丙肾上腺素可能发生的全身血管阻力的显着降低无关。

低血压:低至中等剂量的多巴胺对SVR几乎没有影响,可用于控制由于心输出量不足引起的低血压。在高治疗剂量下,多巴胺的α肾上腺素能作用变得更加突出,因此可以通过减少SVR来纠正低血压。与其他循环失代偿状态一样,血压和尿流未经历极度恶化的患者的预后更好。因此,一旦收缩压和舒张压降低的明确趋势变得明显,建议医生给予多巴胺。

【用法用量】

如果溶液颜色较浅黄色或以任何其他方式变色,请勿进行管理。除非溶液清洁且容器未损坏,否则不要进行管理。丢弃未使用的部分。 不含电解质的葡萄糖溶液不应与血液同时通过相同的输液器给药,因为可能发生红细胞的假性凝集。

不要添加碳酸氢钠或其他碱化物质,因为多巴胺在碱性溶液中失活。

5%葡萄糖注射液中的多巴胺盐酸盐应尽可能注入大静脉,以防止输注部位附近的血管周围组织浸润。外渗可能导致周围组织坏死和脱落。肘窝的大静脉优于手或脚踝的静脉。仅当较大的静脉不可用且患者的病情需要立即注意时,才应使用不太合适的输注部位。医生应尽快切换到更合适的部位,并应连续监测使用的输液部位的自由流动。

当流体膨胀不成问题时,较低浓度的800mcg / mL溶液可能是优选的。浓度为1600 mcg / mL或3200 mcg / mL的溶液在患有液体潴留或需要较慢输注速度的患者中可能是优选的。

给药速度:不建议给予脐动脉导管。

5%葡萄糖注射液中的多巴胺不应通过普通静脉注射器输注,仅通过重力和机械夹具调节。只应使用输液泵,最好是容积泵。

每位患者必须单独滴定至多巴胺所需的血液动力学或肾脏反应。

在滴定至所需的收缩压增加时,可能超过肾反应的最佳剂量率,因此在血液动力学状况稳定后需要降低速率。

如果在接受多巴胺的患者中观察到舒张压的不成比例的升高(即,脉压显着降低),则应降低输注速度并仔细观察患者以获得主要血管收缩活动的进一步证据,除非这种效果是理想的。

超过50 mcg / kg / min的给药率已安全地用于晚期循环代偿失调状态的成人。如果关注不必要的流体膨胀,则优选药物浓度的调整而不是增加浓度较低的稀释液的流速。

当停止输注时,可能需要逐渐减少多巴胺盐的剂量,同时用静脉输液扩大血容量以防止显着的低血压的发展。

【禁忌】

多巴胺盐酸盐不应用于嗜铬细胞瘤患者。

多巴胺不应在未矫正的快速性心律失常或心室颤动的情况下给药。

【INDICATIONS AND USAGE】

Dopamine Hydrochloride in 5% Dextrose Injection, USP is indicated for the correction of hemodynamic imbalances present in shock due to myocardial infarction, trauma, endotoxic septicemia, open heart surgery, renal failure and chronic cardiac decompensation as in refractory congestive failure.

When indicated, restoration of circulatory volume should be instituted or completed with a suitable plasma expander or whole blood, prior to administration of dopamine hydrochloride

Patients most likely to respond to dopamine are those whose physiological parameters (such as urine flow, myocardial function and blood pressure) have not undergone extreme deterioration. Reports indicate that the shorter the time between onset of signs and symptoms and initiation of therapy with volume restoration and dopamine, the better the prognosis.

Poor Perfusion of Vital Organs: Although urine flow is apparently one of the better diagnostic signs for monitoring vital organ perfusion, the physician also should observe the patient for signs of reversal of mental confusion or coma. Loss of pallor, increase in toe temperature or adequacy of nail bed capillary filling also may be observed as indices of adequate dosage. Reported studies indicate that when dopamine is administered before urine flow has decreased to approximately 0.3 mL/minute prognosis is more favorable.

However, it has been observed that in some oliguric or anuric patients, administration of the drug has produced an increase in urine flow which may reach normal levels. The drug also may increase urine flow in patients whose output is within normal limits and thus may help in reducing the degree of preexisting fluid accumulation. Conversely, at higher than optimal doses for a given patient, urinary flow may decrease, requiring a reduction of dosage. Concomitant administration of dopamine and diuretic agents may produce an additive or potentiating effect.

Low Cardiac Output: Dopamine's direct inotropic effect on the myocardium which increases cardiac output at low or moderate doses is related to a favorable prognosis. Increased output has been associated with unchanged or decreased systemic vascular resistance (SVR). The association of static or decreased SVR with low or moderate increases in cardiac output is regarded as a reflection of differential effects on specific vascular beds, with increased resistance in peripheral beds (e.g., femoral), and concurrent decreases in mesenteric and renal vascular beds. Redistribution of blood flow parallels these changes so that an increase in cardiac output is accompanied by an increase in mesenteric and renal blood flow. In many instances the renal fraction of the total cardiac output has been found to increase. Increase in cardiac output produced by dopamine is not associated with substantial decreases in systemic vascular resistance as may occur with isoproterenol.

Hypotension: Low to moderate doses of dopamine, which have little effect on SVR, can be used to manage hypotension due to inadequate cardiac output. At high therapeutic doses, dopamine's αadrenergic action becomes more prominent and thus may correct hypotension due to diminished SVR. As in other circulatory decompensation states, prognosis is better in patients whose blood pressure and urine flow have not undergone extreme deterioration. Therefore, it is suggested the physician administer dopamine as soon as a definite trend toward decreased systolic and diastolic pressure becomes apparent.

【DOSAGE AND ADMINISTRATION】

Do NOT administer if solution is darker than slightly yellow or discolored in any other way. Do NOT administer unless solution is clear and container is undamaged. Discard unused portion.

Dextrose solutions without electrolytes should not be administered simultaneously with blood through the same infusion set because of the possibility that pseudoagglutination of red cells may occur.

Do NOT add sodium bicarbonate or other alkalinizing substance, since dopamine is inactivated in alkaline solution.

Dopamine Hydrochloride in 5% Dextrose Injection should be infused into a large vein whenever possible to prevent the infiltration of perivascular tissue adjacent to the infusion site. Extravasation may cause necrosis and sloughing of the surrounding tissue. Large veins of the antecubital fossa are preferred to veins of the dorsum of the hand or ankle. Less suitable infusion sites should be used only when larger veins are unavailable and the patient's condition requires immediate attention. The physician should switch to a more suitable site as soon as possible and the infusion site in use should be continuously monitored for free flow.

The less concentrated 800 mcg/mL solution may be preferred when fluid expansion is not a problem. The more concentrated 1600 mcg/mL or 3200 mcg/mL solutions, may be preferred in patients with fluid retention or when a slower rate of infusion is desired.

Rate of Administration: Administration into an umbilical artery catheter is not recommended.

Dopamine in 5% Dextrose Injection should not be infused through ordinary intravenous apparatus, regulated only by gravity and mechanical clamps. Only an infusion pump, preferably a volumetric pump, should be used.

Each patient must be individually titrated to the desired hemodynamic or renal response to dopamine.

In titrating to the desired increase in systolic blood pressure, the optimum dosage rate for renal response may be exceeded, thus necessitating a reduction in rate after the hemodynamic condition is stabilized.

If a disproportionate rise in diastolic pressure (i.e., a marked decrease in pulse pressure) is observed in patients receiving dopamine, the infusion rate should be decreased and the patient observed carefully for further evidence of predominant vasoconstrictor activity, unless such an effect is desired.

Administration rates greater than 50 mcg/kg/min have safely been used in adults in advanced circulatory decompensation states. If unnecessary fluid expansion is of concern, adjustment of drug concentration may be preferred over increasing the flow rate of a less concentrated dilution.

When discontinuing the infusion, it may be necessary to gradually decrease the dose of dopamine HCl while expanding the blood volume with intravenous fluids to prevent the development of marked hypotension.

【CONTRAINDICATIONS】

Dopamine hydrochloride should not be used in patients with pheochromocytoma.

Dopamine should not be administered in the presence of uncorrected tachyarrhythmias or ventricular fibrillation.

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详细处方信息以本药内容附件PDF文件(201932017585222.pdf)的“原文Priscribing Information”为准
---------------------------------------------------------------

更新日期: 2019-10-19
附件:
201932017585222.pdf    

 
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