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Paper I — 2016 February (2010 Scheme) — Q4

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Paper I
2016 February (2010 Scheme) · 40 marks · 120 min

Question

Dopamine in cardiogenic shock.

Q43 marksShort Notes

Answer

Dopamine is used in cardiogenic shock for its dose-dependent cardiovascular effects.

Dose-dependent actions

  • Low dose (0.5–2 mcg/kg/min): D1 receptor stimulation — renal/mesenteric vasodilatation
  • Intermediate dose (2–10 mcg/kg/min): β1 receptor stimulation — increases heart rate and myocardial contractility, improving cardiac output — the dose range most relevant in cardiogenic shock
  • High dose (>10 mcg/kg/min): α1 receptor stimulation — vasoconstriction, raises blood pressure, but at the cost of increased afterload and myocardial oxygen demand

Rationale in cardiogenic shock

  • Improves cardiac contractility and cardiac output at intermediate doses, helping restore perfusion, while a starting low dose may help maintain renal perfusion
  • Requires careful titration and monitoring, as high doses can worsen cardiac workload and precipitate arrhythmias

Adverse effects

  • Tachycardia, arrhythmias
  • Increased myocardial oxygen demand
  • Tissue necrosis on extravasation
  1. 1Adrenergic System

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