{"id":56660,"date":"2024-02-27T17:02:52","date_gmt":"2024-02-27T17:02:52","guid":{"rendered":"https:\/\/medsname.com\/domin-injection\/"},"modified":"2026-05-01T10:49:13","modified_gmt":"2026-05-01T10:49:13","slug":"domin-injection","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/domin-injection\/","title":{"rendered":"Domin Injection"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div class=\"medsbase-tldr-answer\" style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Domin Injection?<\/h3>\n<p style=\"margin:0;\"><strong>Domin Injection<\/strong> je steriln\u00ed koncentr\u00e1t <strong>dopamin hydrochloridu 40 mg\/ml<\/strong> (5ml ampule = 200 mg) pou\u017e\u00edvan\u00fd k <strong>intraven\u00f3zn\u00ed infuze v kritick\u00e9 p\u00e9\u010di<\/strong>. Je to <strong>vazopresor a pozitivn\u00ed inotropikum<\/strong> ur\u010den\u00e9 pro kr\u00e1tkodobou hemodynamickou podporu u <strong>\u0161oku<\/strong> (septick\u00e9ho, kardiogenn\u00edho, hypovolemick\u00e9ho po n\u00e1hrad\u011b objemu), <strong>akutn\u00edho srde\u010dn\u00edho selh\u00e1n\u00ed s hypotenz\u00ed<\/strong>, a <strong>symptomatick\u00e9 bradykardie<\/strong>. Mus\u00ed b\u00fdt na\u0159ed\u011bn a pod\u00e1v\u00e1n kontinu\u00e1ln\u00ed intraven\u00f3zn\u00ed infuz\u00ed se sledov\u00e1n\u00edm srde\u010dn\u00ed \u010dinnosti a krevn\u00edho tlaku, ide\u00e1ln\u011b prost\u0159ednictv\u00edm centr\u00e1ln\u00edho \u017eiln\u00edho kat\u00e9tru. Jedn\u00e1 se o <strong>l\u00e9k pro pou\u017eit\u00ed v nemocnici<\/strong> \u2014 nen\u00ed vhodn\u00fd k samopod\u00e1n\u00ed ani k ambulantn\u00edmu pou\u017eit\u00ed.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch <a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<p><strong>Domin Injection 40 mg\/mL (5 mL ampule)<\/strong> je steriln\u00ed koncentrovan\u00fd roztok <strong>hydrochloridu dopaminu<\/strong>. Ka\u017ed\u00e1 5 mL ampule obsahuje 200 mg dopaminu a je ur\u010dena k na\u0159ed\u011bn\u00ed a kontinu\u00e1ln\u00ed intraven\u00f3zn\u00ed infuzi v nemocni\u010dn\u00edm prost\u0159ed\u00ed. Dopamin je na Seznamu z\u00e1kladn\u00edch l\u00e9\u010div WHO.<\/p>\n<p>Dopamin je endogenn\u00ed katecholamin \u2014 p\u0159\u00edm\u00fd metabolick\u00fd prekurzor noradrenalinu a tak\u00e9 samostatn\u00fd neurotransmiter. P\u0159i pod\u00e1n\u00ed intraven\u00f3zn\u00ed infuz\u00ed ve farmakologick\u00fdch d\u00e1vk\u00e1ch p\u016fsob\u00ed jako <strong>vazopresor a kardiostimulant s d\u00e1vkov\u011b z\u00e1visl\u00fdm \u00fa\u010dinkem<\/strong>, jeho\u017e efekty se m\u011bn\u00ed podle rychlosti infuze:<\/p>\n<ul>\n<li><strong>N\u00edzk\u00e1 d\u00e1vka (1\u20135 mcg\/kg\/min \u2014 \u201cren\u00e1ln\u00ed d\u00e1vka\u201d):<\/strong> dopaminergn\u00ed receptory; tradi\u010dn\u011b se p\u0159edpokl\u00e1dalo zlep\u0161en\u00ed ren\u00e1ln\u00ed perfuze, a\u010dkoli modern\u00ed d\u016fkazy nepodporuj\u00ed rutinn\u00ed pou\u017eit\u00ed \u201cren\u00e1ln\u00ed d\u00e1vky\u201d p\u0159i oligurii<\/li>\n<li><strong>St\u0159edn\u00ed d\u00e1vka (5\u201310 mcg\/kg\/min):<\/strong> beta-1 adrenergn\u00ed \u00fa\u010dinky \u2014 zv\u00fd\u0161en\u00e1 kontraktilita myokardu, srde\u010dn\u00ed v\u00fddej a minutov\u00fd objem<\/li>\n<li><strong>Vysok\u00e1 d\u00e1vka (&gt; 10 mcg\/kg\/min):<\/strong> alfa-1 adrenergn\u00ed \u00fa\u010dinky \u2014 perifern\u00ed vazokonstrikce a vzestup syst\u00e9mov\u00e9 vaskul\u00e1rn\u00ed rezistence<\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:16px 0 24px;border-radius:4px;\">\n<p style=\"margin:0;\"><strong>Pouze pro nemocni\u010dn\u00ed pou\u017eit\u00ed.<\/strong> Domin Injection je l\u00e9k pro kritickou p\u00e9\u010di. Mus\u00ed b\u00fdt pod\u00e1v\u00e1n kvalifikovan\u00fdm zdravotn\u00edkem v nemocnici, jednotce intenzivn\u00ed p\u00e9\u010de nebo na pohotovostn\u00edm odd\u011blen\u00ed za kontinu\u00e1ln\u00edho monitorov\u00e1n\u00ed srde\u010dn\u00ed \u010dinnosti a s p\u0159ipraven\u00fdm nouzov\u00fdm vybaven\u00edm. <em>ne<\/em> Nen\u00ed vhodn\u00fd k samopod\u00e1v\u00e1n\u00ed, ambulantn\u00edmu u\u017eit\u00ed nebo dom\u00e1c\u00edmu u\u017eit\u00ed za \u017e\u00e1dn\u00fdch okolnost\u00ed.<\/p>\n<\/div>\n<h2 class=\"wp-block-heading\">K \u010demu se Domin Injection pou\u017e\u00edv\u00e1?<\/h2>\n<ul>\n<li><strong>Septick\u00fd \u0161ok<\/strong> \u2014 kdy\u017e samotn\u00e1 tekutinov\u00e1 resuscitace nesta\u010d\u00ed k obnoven\u00ed krevn\u00edho tlaku (noradrenalin je prvn\u00ed volbou podle v\u011bt\u0161iny modern\u00edch doporu\u010den\u00ed, ale dopamin z\u016fst\u00e1v\u00e1 uzn\u00e1vanou alternativou)<\/li>\n<li><strong>Kardiogenn\u00ed \u0161ok<\/strong> \u2014 zejm\u00e9na kdy\u017e je srde\u010dn\u00ed frekvence pomal\u00e1 a je vy\u017eadov\u00e1na inotropn\u00ed podpora<\/li>\n<li><strong>Akutn\u00ed srde\u010dn\u00ed selh\u00e1n\u00ed s hypotenz\u00ed<\/strong> \u2014 n\u00edzk\u00fd srde\u010dn\u00ed v\u00fddej se \u0161patnou perfuz\u00ed tk\u00e1n\u00ed<\/li>\n<li><strong>Symptomatick\u00e1 bradykardie<\/strong> \u2014 kdy\u017e atropin a transkut\u00e1nn\u00ed kardiostimulace nejsou dostupn\u00e9 nebo jsou nedostate\u010dn\u00e9<\/li>\n<li><strong>N\u00edzk\u00fd srde\u010dn\u00ed v\u00fddej po kardiochirurgick\u00e9m z\u00e1kroku<\/strong><\/li>\n<li><strong>Distributivn\u00ed \u0161ok<\/strong> po po\u010d\u00e1te\u010dn\u00ed tekutinov\u00e9 resuscitaci<\/li>\n<li><strong>T\u011b\u017ek\u00e1 anafylaxe s refraktern\u00ed hypotenz\u00ed<\/strong> (jako druh\u00e1 volba po adrenalinu a tekutin\u00e1ch)<\/li>\n<\/ul>\n<p>Modern\u00ed doporu\u010den\u00ed pro l\u00e9\u010dbu sepse (Surviving Sepsis 2021) uv\u00e1d\u011bj\u00ed <strong>noradrenalin jako vazopresor prvn\u00ed volby<\/strong>, s dopaminem vyhrazen\u00fdm jako alternativou u vybran\u00fdch pacient\u016f (nap\u0159. u pacient\u016f s bradykardi\u00ed bez rizika arytmie). Pou\u017eit\u00ed dopaminu k ren\u00e1ln\u00ed protekci (\u201cren\u00e1ln\u00ed d\u00e1vka dopaminu\u201d) nen\u00ed podpo\u0159eno sou\u010dasn\u00fdmi d\u016fkazy a ji\u017e se nedoporu\u010duje jako rutinn\u00ed postup.<\/p>\n<h2 class=\"wp-block-heading\">Jak funguje dopamin?<\/h2>\n<p>Dopamin p\u016fsob\u00ed na t\u0159i hlavn\u00ed receptorov\u00e9 syst\u00e9my v z\u00e1vislosti na d\u00e1vkov\u00e1n\u00ed:<\/p>\n<ul>\n<li><strong>Dopaminov\u00e9 receptory (D1, D2):<\/strong> ren\u00e1ln\u00ed, mezenterick\u00e1 a koron\u00e1rn\u00ed vazodilatace p\u0159i n\u00edzk\u00fdch d\u00e1vk\u00e1ch<\/li>\n<li><strong>Beta-1 adrenergn\u00ed receptory:<\/strong> myokardi\u00e1ln\u00ed kontraktilita a srde\u010dn\u00ed frekvence p\u0159i st\u0159edn\u00edch d\u00e1vk\u00e1ch; zvy\u0161uje srde\u010dn\u00ed v\u00fddej<\/li>\n<li><strong>Alfa-1 adrenergn\u00ed receptory:<\/strong> perifern\u00ed arteri\u00e1ln\u00ed vazokonstrikce p\u0159i vysok\u00fdch d\u00e1vk\u00e1ch; zvy\u0161uje st\u0159edn\u00ed arteri\u00e1ln\u00ed tlak<\/li>\n<\/ul>\n<p>V praxi v\u011bt\u0161ina pacient\u016f dost\u00e1v\u00e1 dopamin v st\u0159edn\u011b vysok\u00e9m a\u017e vysok\u00e9m d\u00e1vkov\u00e9m rozmez\u00ed (5\u201320 mcg\/kg\/min), kde se p\u0159ekr\u00fdvaj\u00ed beta a alfa \u00fa\u010dinky. \u010cist\u00e9 infuze v \u201cren\u00e1ln\u00ed d\u00e1vce\u201d se ji\u017e nedoporu\u010duj\u00ed pro ochranu ledvin.<\/p>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed a pod\u00e1v\u00e1n\u00ed Domin Injection<\/h2>\n<ul>\n<li><strong>Na\u0159ed\u011bn\u00ed:<\/strong> jedna 200 mg ampule v 250 mL 0,9% roztoku chloridu sodn\u00e9ho nebo 5% gluk\u00f3zy poskytne koncentraci 800 mcg\/mL. Vy\u0161\u0161\u00ed koncentrace (1 600 mcg\/mL) se pou\u017e\u00edvaj\u00ed p\u0159i pot\u0159eb\u011b omezen\u00ed p\u0159\u00edjmu tekutin.<\/li>\n<li><strong>Zp\u016fsob pod\u00e1n\u00ed:<\/strong> pouze kontinu\u00e1ln\u00ed intraven\u00f3zn\u00ed infuze. Centr\u00e1ln\u00ed \u017eiln\u00ed p\u0159\u00edstup je siln\u011b doporu\u010den \u2013 perifern\u00ed extravazace m\u016f\u017ee zp\u016fsobit tk\u00e1\u0148ovou nekr\u00f3zu a ischemii prst\u016f.<\/li>\n<li><strong>Po\u010d\u00e1te\u010dn\u00ed d\u00e1vka:<\/strong> 2\u20135 mcg\/kg\/min; titrujte nahoru v kroc\u00edch po 2\u20135 mcg\/kg\/min ka\u017ed\u00fdch 10\u201330 minut na z\u00e1klad\u011b krevn\u00edho tlaku, srde\u010dn\u00ed frekvence, v\u00fddeje mo\u010di a p\u0159\u00edznak\u016f tk\u00e1\u0148ov\u00e9 perfuze.<\/li>\n<li><strong>Obvykl\u00e9 \u00fa\u010dinn\u00e9 rozmez\u00ed:<\/strong> 5\u201320 mcg\/kg\/min; d\u00e1vky nad 20 mcg\/kg\/min z\u0159\u00eddka p\u0159in\u00e1\u0161ej\u00ed dal\u0161\u00ed benefit a jsou spojeny s tachyarytmiemi a zhor\u0161en\u00fdm v\u00fdsledkem.<\/li>\n<li><strong>Monitorov\u00e1n\u00ed:<\/strong> kontinu\u00e1ln\u00ed EKG, invazivn\u00ed m\u011b\u0159en\u00ed arteri\u00e1ln\u00edho tlaku, centr\u00e1ln\u00ed \u017eiln\u00ed tlak nebo ekvivalent, v\u00fddej mo\u010di, s\u00e9rov\u00fd lakt\u00e1t a klinick\u00e9 p\u0159\u00edznaky perfuze.<\/li>\n<li><strong>Sni\u017eov\u00e1n\u00ed d\u00e1vky:<\/strong> postupn\u011b sni\u017eujte (sni\u017ete rychlost o 25\u201350% ka\u017ed\u00fdch 10\u201330 minut na z\u00e1klad\u011b hemodynamick\u00e9 odpov\u011bdi). N\u00e1hl\u00e9 p\u0159eru\u0161en\u00ed m\u016f\u017ee zp\u016fsobit hypotenzi.<\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:16px 0;border-radius:4px;\">\n<p style=\"margin:0;\"><strong>Extravazace je urgentn\u00ed stav.<\/strong> Pokud dopamin unik\u00e1 z m\u00edsta infuze do okoln\u00ed tk\u00e1n\u011b, zp\u016fsobuje z\u00e1va\u017enou lok\u00e1ln\u00ed vazokonstrikci a m\u016f\u017ee v\u00e9st k nekr\u00f3ze k\u016f\u017ee. Infuzi okam\u017eit\u011b zastavte, neodstra\u0148ujte kanylu p\u0159ed odborn\u00fdm poradenstv\u00edm a co nejd\u0159\u00edve infiltrujte oblast fentolaminem (5\u201310 mg na\u0159ed\u011bn\u00fdm v 10\u201315 ml fyziologick\u00e9ho roztoku).<\/p>\n<\/div>\n<h2 class=\"wp-block-heading\">Kdo by nem\u011bl dost\u00e1vat injekci Domin?<\/h2>\n<ul>\n<li>Zn\u00e1m\u00e1 p\u0159ecitliv\u011blost na dopamin<\/li>\n<li><strong>Feochromocytom<\/strong> \u2014 nekompenzovan\u00e1 alfa stimulace zp\u016fsobuje hypertenzn\u00ed krizi<\/li>\n<li><strong>Nekorigovan\u00e9 tachyarytmie<\/strong> \u2014 dopamin je proarytmick\u00fd<\/li>\n<li><strong>Fibrilace komor<\/strong><\/li>\n<li><strong>Nekorigovan\u00e1 hypovol\u00e9mie<\/strong> \u2014 nejprve je nutn\u00e1 volumov\u00e1 resuscitace; pou\u017eit\u00ed vazopresoru na pr\u00e1zdn\u00fd syst\u00e9m je \u0161kodliv\u00e9<\/li>\n<li>Pou\u017e\u00edvejte s extr\u00e9mn\u00ed opatrnost\u00ed u: ned\u00e1vn\u00e9ho infarktu myokardu, ischemick\u00e9 choroby srde\u010dn\u00ed, onemocn\u011bn\u00ed perifern\u00edch c\u00e9v, Buergerovy choroby<\/li>\n<li>Sou\u010dasn\u00e9 u\u017e\u00edv\u00e1n\u00ed MAOI \u2014 v\u00fdrazn\u011b zesiluje presorick\u00fd \u00fa\u010dinek (sni\u017ete d\u00e1vku dopaminu na jednu desetinu)<\/li>\n<li>Sou\u010dasn\u00e9 u\u017e\u00edv\u00e1n\u00ed fenytoinu \u2014 m\u016f\u017ee zp\u016fsobit hypotenzi a bradykardii<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<ul>\n<li><strong>\u010cast\u00e9:<\/strong> tachykardie, ektopick\u00e9 stahy, hypertenze p\u0159i vysok\u00fdch d\u00e1vk\u00e1ch, nauzea a zvracen\u00ed<\/li>\n<li><strong>\u010cast\u00e9 p\u0159i vysok\u00fdch d\u00e1vk\u00e1ch:<\/strong> komorov\u00e9 a supraventrikul\u00e1rn\u00ed arytmie, angina pectoris, hypertenze<\/li>\n<li><strong>Lok\u00e1ln\u011b:<\/strong> bolest v m\u00edst\u011b infuze, flebitida, nekr\u00f3za tk\u00e1n\u011b p\u0159i extravazaci<\/li>\n<li><strong>Dal\u0161\u00ed:<\/strong> perifern\u00ed vazokonstrikce s chladn\u00fdmi kon\u010detinami a ischemi\u00ed prst\u016f, zhor\u0161en\u00ed myokardi\u00e1ln\u00ed ischemie, potla\u010den\u00ed tyreoid\u00e1ln\u00edho stimula\u010dn\u00edho hormonu, imunosupresivn\u00ed \u00fa\u010dinek (relevantn\u00ed na JIP)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<ul>\n<li><strong>IMAO:<\/strong> extr\u00e9mn\u00ed opatrnost \u2014 pou\u017eijte jednu desetinu obvykl\u00e9 po\u010d\u00e1te\u010dn\u00ed d\u00e1vky<\/li>\n<li><strong>Fenytoin:<\/strong> m\u016f\u017ee zp\u016fsobit t\u011b\u017ekou hypotenzi a bradykardii<\/li>\n<li><strong>Jin\u00e9 vazopresory (noradrenalin, adrenalin, vazopresin):<\/strong> aditivn\u00ed kardi\u00e1ln\u00ed a vaskul\u00e1rn\u00ed \u00fa\u010dinky; \u010dasto kombinov\u00e1ny na JIP<\/li>\n<li><strong>Betablok\u00e1tory:<\/strong> m\u016f\u017ee sn\u00ed\u017eit inotropn\u00ed odpov\u011b\u010f<\/li>\n<li><strong>Alfa-blok\u00e1tory:<\/strong> sni\u017euj\u00ed presorickou odpov\u011b\u010f<\/li>\n<li><strong>Tricyklick\u00e1 antidepresiva, kokain, alkaloidy n\u00e1melu:<\/strong> zesiluj\u00ed presorick\u00fd efekt<\/li>\n<li><strong>Inhala\u010dn\u00ed anestetika (halotan, cyklopropan):<\/strong> mohou zv\u00fd\u0161it citlivost myokardu na dopaminem vyvolan\u00e9 arytmie<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Objedn\u00e1vky a dod\u00e1n\u00ed<\/h2>\n<p>MedsBase nab\u00edz\u00ed celosv\u011btovou dopravu pro ka\u017edou objedn\u00e1vku. Objedn\u00e1vky jsou odes\u00edl\u00e1ny v diskr\u00e9tn\u00edch obalech a dod\u00e1v\u00e1ny v origin\u00e1ln\u00edch v\u00fdrobn\u00edch balen\u00edch. Pokud je po\u017eadovan\u00e1 s\u00edla nebo velikost balen\u00ed nedostupn\u00e1, kontaktujte z\u00e1kaznickou podporu pro odhad dodac\u00ed lh\u016fty.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:20px 0;border-radius:4px;\">\n<p style=\"margin:0;\"><strong>Zdravotn\u00ed prohl\u00e1\u0161en\u00ed.<\/strong> Informace na t\u00e9to str\u00e1nce slou\u017e\u00ed pouze pro obecn\u00e9 vzd\u011bl\u00e1vac\u00ed \u00fa\u010dely. Nejsou n\u00e1hradou za rady va\u0161eho l\u00e9ka\u0159e nebo l\u00e9k\u00e1rn\u00edka. P\u0159ed zah\u00e1jen\u00edm, ukon\u010den\u00edm nebo zm\u011bnou l\u00e9\u010dby se pora\u010fte s kvalifikovan\u00fdm zdravotnick\u00fdm pracovn\u00edkem.<\/p>\n<\/div>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">K \u010demu se pou\u017e\u00edv\u00e1 injekce Domin?<\/h3>\n<p>Injekce Domin (dopamin HCl 40 mg\/mL) se pou\u017e\u00edv\u00e1 v kritick\u00e9 p\u00e9\u010di pro hemodynamickou podporu p\u0159i \u0161oku (septick\u00e9m, kardiogenn\u00edm, distributivn\u00edm), akutn\u00edm srde\u010dn\u00edm selh\u00e1n\u00ed s hypotenz\u00ed a symptomatick\u00e9 bradykardii. Jedn\u00e1 se o nemocni\u010dn\u00ed l\u00e9k pod\u00e1van\u00fd kontinu\u00e1ln\u00ed intraven\u00f3zn\u00ed infuz\u00ed se srde\u010dn\u00edm monitorov\u00e1n\u00edm.<\/p>\n<h3 class=\"wp-block-heading\">Je injekce Domin l\u00e9kem na krevn\u00ed tlak?<\/h3>\n<p>Zvy\u0161uje krevn\u00ed tlak, tak\u017ee v doslovn\u00e9m smyslu ano \u2014 ale pou\u017e\u00edv\u00e1 se pouze v nouzov\u00fdch situac\u00edch a na jednotk\u00e1ch intenzivn\u00ed p\u00e9\u010de u pacient\u016f v \u0161oku nebo s nebezpe\u010dn\u011b n\u00edzk\u00fdm krevn\u00edm tlakem. Nen\u00ed to l\u00e9k na chronickou hypertenzi; v tomto kontextu by byla nevhodn\u00e1 t\u0159\u00edda a potenci\u00e1ln\u011b nebezpe\u010dn\u00e1.<\/p>\n<h3 class=\"wp-block-heading\">M\u016f\u017ee b\u00fdt injekce Domin pod\u00e1v\u00e1na doma?<\/h3>\n<p>Ne. Dopamin je l\u00e9k kritick\u00e9 p\u00e9\u010de, kter\u00fd vy\u017eaduje kontinu\u00e1ln\u00ed intraven\u00f3zn\u00ed infuzi, monitorov\u00e1n\u00ed srde\u010dn\u00ed a arteri\u00e1ln\u00ed tlakov\u00e9 k\u0159ivky a okam\u017eit\u00fd p\u0159\u00edstup k nouzov\u00e9mu vybaven\u00ed. Pod\u00e1v\u00e1 se v nemocnic\u00edch, na JIP a na pohotovostn\u00edch odd\u011blen\u00edch kvalifikovan\u00fdmi kliniky \u2014 ne doma, ne v ambulantn\u00edch za\u0159\u00edzen\u00edch, ne pacientem samotn\u00fdm.<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d se dopamin pod\u00e1v\u00e1 kontinu\u00e1ln\u00ed infuz\u00ed nam\u00edsto jednor\u00e1zov\u00e9 injekce?<\/h3>\n<p>Dopamin m\u00e1 v ob\u011bhu polo\u010das pouze 2 minuty. Jednor\u00e1zov\u00e1 bolusov\u00e1 d\u00e1vka by m\u011bla \u00fa\u010dinek trvaj\u00edc\u00ed minutu nebo dv\u011b maxim\u00e1ln\u011b. Pro udr\u017een\u00ed stabiln\u00ed hemodynamick\u00e9 podpory mus\u00ed b\u00fdt pod\u00e1v\u00e1n kontinu\u00e1ln\u00ed infuz\u00ed \u0159\u00edzenou rychlost\u00ed, titrovanou podle krevn\u00edho tlaku a klinick\u00e9 odpov\u011bdi minutu po minut\u011b.<\/p>\n<h3 class=\"wp-block-heading\">Je dopamin tot\u00e9\u017e co noradrenalin?<\/h3>\n<p>Oba jsou vazopresory pou\u017e\u00edvan\u00e9 p\u0159i \u0161oku, ale li\u0161\u00ed se. Dopamin m\u00e1 dopaminergn\u00ed, beta a alfa \u00fa\u010dinky v z\u00e1vislosti na d\u00e1vce. Noradrenalin je t\u00e9m\u011b\u0159 \u010dist\u011b alfa-adrenergn\u00ed vazopresor s ur\u010dit\u00fdm beta-1 \u00fa\u010dinkem. Modern\u00ed doporu\u010den\u00ed pro sepsi (Surviving Sepsis 2021) doporu\u010duj\u00ed noradrenalin jako l\u00e9k prvn\u00ed volby; dopamin je alternativou u vybran\u00fdch pacient\u016f, zejm\u00e9na t\u011bch s bradykardi\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Chr\u00e1n\u00ed dopamin ledviny?<\/h3>\n<p>Nespolehliv\u011b. \u201cRen\u00e1ln\u00ed d\u00e1vka dopaminu\u201d (1\u20133 mcg\/kg\/min) se historicky pou\u017e\u00edvala k ochran\u011b ledvin nebo k l\u00e9\u010db\u011b oligurie. Randomizovan\u00e9 studie a metaanal\u00fdzy neprok\u00e1zaly klinicky v\u00fdznamn\u00fd benefit na ren\u00e1ln\u00ed funkci ani na mortalitu a sou\u010dasn\u00e1 doporu\u010den\u00ed nedoporu\u010duj\u00ed rutinn\u00ed pou\u017eit\u00ed pro tuto indikaci.<\/p>\n<h3 class=\"wp-block-heading\">Co je extravazace a pro\u010d je to urgentn\u00ed stav?<\/h3>\n<p>Extravazace je, kdy\u017e IV tekutina unik\u00e1 do okoln\u00ed tk\u00e1n\u011b m\u00edsto do \u017e\u00edly. U dopaminu m\u016f\u017ee intenzivn\u00ed lok\u00e1ln\u00ed vazokonstrikce zp\u016fsobit nekr\u00f3zu tk\u00e1n\u011b, po\u0161kozen\u00ed k\u016f\u017ee a (v t\u011b\u017ek\u00fdch p\u0159\u00edpadech) ischemii prst\u016f. Pokud k n\u00ed dojde, mus\u00ed b\u00fdt infuze okam\u017eit\u011b zastavena a do posti\u017een\u00e9 oblasti by m\u011bl b\u00fdt co nejd\u0159\u00edve aplikov\u00e1n fentolamin (alfa-blok\u00e1tor).<\/p>\n<h3 class=\"wp-block-heading\">M\u016f\u017ee dopamin zp\u016fsobit arytmie?<\/h3>\n<p>Ano \u2014 zejm\u00e9na p\u0159i vy\u0161\u0161\u00edch d\u00e1vk\u00e1ch (&gt; 10 mcg\/kg\/min). Vyskytuj\u00ed se tachykardie, extrasystoly, fibrilace s\u00edn\u00ed a komorov\u00e1 tachykardie. B\u011bhem l\u00e9\u010dby dopaminem je standardn\u00ed kontinu\u00e1ln\u00ed monitorov\u00e1n\u00ed srde\u010dn\u00ed \u010dinnosti.<\/p>\n<h3 class=\"wp-block-heading\">Jak se vypo\u010d\u00edt\u00e1v\u00e1 d\u00e1vka?<\/h3>\n<p>Dopamin se d\u00e1vkuje v mikrogramech na kilogram t\u011blesn\u00e9 hmotnosti za minutu (mcg\/kg\/min). Po\u010d\u00e1te\u010dn\u00ed d\u00e1vka je obvykle 2\u20135 mcg\/kg\/min, s titrac\u00ed nahoru na z\u00e1klad\u011b krevn\u00edho tlaku a perfuze. P\u0159edepisuj\u00edc\u00ed t\u00fdm vypo\u010d\u00edt\u00e1 rychlost infuze z hmotnosti pacienta a koncentrace ampule.<\/p>\n<h3 class=\"wp-block-heading\">M\u016f\u017ee b\u00fdt Domin Injection pod\u00e1v\u00e1n do svalu?<\/h3>\n<p>Ne \u2014 dopamin je ur\u010den pouze pro kontinu\u00e1ln\u00ed IV infuzi. Nelze jej pod\u00e1vat intramuskul\u00e1rn\u011b ani subkut\u00e1nn\u011b.<\/p>\n<h3 class=\"wp-block-heading\">Pou\u017e\u00edv\u00e1 se Domin Injection u d\u011bt\u00ed?<\/h3>\n<p>Ano, v d\u00e1vk\u00e1ch podle hmotnosti. Pediatrick\u00fd dopamin se pou\u017e\u00edv\u00e1 v neonat\u00e1ln\u00ed a pediatrick\u00e9 intenzivn\u00ed p\u00e9\u010di p\u0159i \u0161oku a stavech s n\u00edzk\u00fdm srde\u010dn\u00edm v\u00fddejem, pod odborn\u00fdm dohledem.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Souvisej\u00edc\u00ed alternativy<\/h3>\n<p>Dal\u0161\u00ed produkty v <strong>Chronick\u00e1 onemocn\u011bn\u00ed<\/strong> kter\u00e9 z\u00e1kazn\u00edci tak\u00e9 prohl\u00ed\u017eej\u00ed:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/budecort-inhaler\/\">Budecort Inhaler<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/neurobion-forte-rf-injection\/\">Neurobion Forte RF Injekce (Methylkobalamin + B6 + B3) \u2014 Oprava nerv\u016f<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/pirox-gel\/\">Pirox Gel<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/xepar\/\">Xepar<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/topicon\/\">Topicon<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>\u2705 Zlep\u0161uje krevn\u00ed ob\u011bh<br \/>\n\u2705 Zlep\u0161uje funkci ledvin<br \/>\n\u2705 Zvl\u00e1d\u00e1 \u0161okov\u00fd stav<br \/>\n\u2705 L\u00e9\u010d\u00ed n\u00edzk\u00fd krevn\u00ed tlak<br \/>\n\u2705 Reguluje srde\u010dn\u00ed frekvenci<\/p>\n<p>Domin Injection obsahuje dopamin.<\/p>","protected":false},"featured_media":56661,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3260],"product_tag":[4139,4140],"class_list":{"0":"post-56660","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-heart-blood-pressure","9":"product_tag-domin-injection","10":"product_tag-dopamine","12":"first","13":"instock","14":"shipping-taxable","15":"purchasable","16":"product-type-variable","17":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/56660","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=56660"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/56661"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=56660"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=56660"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=56660"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=56660"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}