Bivins B A, Rapp R P, Griffen W O, Blouin R, Bustrack J
Arch Surg. 1978 Mar;113(3):245-9. doi: 10.1001/archsurg.1978.01370150017002.
Five critically ill patients received dopamine hydrochloride intravenously to support their blood pressure. When seizures developed, intravenous phenytoin sodium therapy was begun. Coincident with the infusion of phenytoin, the blood pressure, which was stable on the dopamine infusion, declined rapidly. Analysis of these cases led to a hypothesis that the interaction of dopamine and phenytoin produced the hypotension. When this hypothesis was tested in the normovolemic dog, intravenous dopamine produced no change in the blood pressure, and the addition of a phenytoin infusion had little effect. In animals rendered hypovolemic and hypotensive by bleeding, intravenous dopamine returned the blood pressure to the prebleeding level. At this point, an infusion of phenytoin produced a sustained decrease in the blood pressure. The mechanism of this action may be related to a combination of catecholamine depletion and myocardial depression.
五名重症患者静脉注射盐酸多巴胺以维持血压。当出现癫痫发作时，开始静脉注射苯妥英钠治疗。在输注苯妥英钠的同时，原本在输注多巴胺时稳定的血压迅速下降。对这些病例的分析得出一个假设，即多巴胺和苯妥英钠的相互作用导致了低血压。当在血容量正常的狗身上检验这一假设时，静脉注射多巴胺未使血压发生变化，加入苯妥英钠输注也几乎没有影响。在因出血而导致血容量减少和低血压的动物中，静脉注射多巴胺可使血压恢复到出血前水平。此时，输注苯妥英钠会使血压持续下降。这种作用机制可能与儿茶酚胺耗竭和心肌抑制的综合作用有关。
