Drug information of Dobutamine

Mechanism of effect

Dobutamine directly stimulates beta-1 receptors of the heart to increase myocardial contractility and stroke volume, resulting in increased cardiac output.

Pharmacodynamic

Dobutamine is a direct-acting inotropic agent whose primary activity results from stimulation of the beta-adrenoceptors of the heart while producing comparatively mild chronotropic, hypertensive, arrhythmogenic, and vasodilative effects.

Dobutamine acts primarily on beta-1 adrenergic receptors, with little effect on beta-2 or alpha receptors. It does not cause the release of endogenous norepinephrine, as does dopamine.

 Dobutamine is indicated when parenteral therapy is necessary for inotropic support in the short-term treatment of patients with cardiac decompensation due to depressed contractility resulting either from organic heart disease or from cardiac surgical procedures.

Pharmacokinetics

Absorption

Onset: 1-10 min

Duration: 10 min

Time to peak effect: ~15 min

Distribution

Vd: 0.2 L/kg

Metabolism

Metabolized in tissues and liver by catechol-O-methyl transferase

Metabolites: Glucuronide conjugate, 3-0-methylated dobutamine (inactive)

Elimination

Half-life: 2 min

Clearance: 90 mL/kg/min

Excretion: Urine

Drug indications

Congestive heart failure

Dosage

Usual Adult Dose for Congestive Heart Failure:

Initial dose: 0.5 to 1 mcg/kg/min IV infusion
Maintenance dose: 2 to 20 mcg/kg/min IV infusion
Maximum dose: 40 mcg/kg/min IV infusion

Usual Pediatric Dose for Congestive Heart Failure:

Initial dose: 0.5 to 1 mcg/kg/min IV infusion
Maintenance dose: 2 to 20 mcg/kg/min IV infusion
Maximum dose: 40 mcg/kg/min IV infusion

Side effects

Fever , Headache , nausea , chest pain , Tachycardia , vomiting , palpitations , Hypokalemia , stinging , shortness of breath

Interactions

Drospirenone , Amitriptyline , Trimipramine , Desipramine , Nortriptyline , Carvedilol , Clomipramine , Amoxapine , Doxepin , protriptyline , Doxapram , Atosiban

Alerts

1. You should not use dobutamine if you are allergic to it.
2. To make sure dobutamine is safe for you, tell your doctor if you have:

• high blood pressure;
• a heart valve disorder; or
• asthma or sulfite allergy.

Points of recommendation

• During the administration of dobutamine injection, as with any adrenergic agent,ECG and blood pressure should be continuously monitored. .
• Hypovolemiashould be corrected with suitable volume expanders before treatment with dobutamine is instituted.
• Dobutamine, like other ß2- agonists, can produce a mild reduction in serumpotassium concentration, rarely to hypokalemic levels. Accordingly, consideration should be given to monitoring serum potassium.

Pregnancy level

B

Related drugs

Dopamine , Arbutamine