Dobutamine
Cardiac Therapy · Beta-1 agonist
Indications
Cardiac inotropic agent, parenteral therapy for inotropic support in the short term treatment of adults with cardiac decompensation due to depressed contractability resulting either from organic heart disease or from cardiac surgical procedure.
Dosage
Adults: 2.5-20 mcg/kg/min; max: 40 mcg/kg/min, titrate to desired response. Children: Inotropic support in low cardiac output states, after cardiac surgery, cardiomyopathies, shock: Continuous IV infusion. Neonate, initially 5 mcg/kg/minute, adjusted according to response to 2-15 mcg/ kg/minute; max. 20 mcg/kg/minute; 1 mth-18 yr, initially 5 mcg/kg/minute adjusted according to response to 2-20 mcg/kg/minute.
Administration
IV: Always administer via inf device; administer into large vein. Reconstitution: Dilute concentrate with at least 50 mL compatible IV soln. A common dilution is 500 mg (40 mL from 250 mL bag) in 210 mL D5W or NS to yield 2000 mcg/mL or dilute 1000 mg (80 mL from 250 mL bag) in 170 mL D5W or NS to yield 4000 mcg/mL. Adjust max conc. according to patient’s fluid requirements as prescribed. Do not exceed 5000 mcg/mL. Compatibility: Stable in D5LR, D5 ½NS, D5NS, D5W, D10W, LR, ½NS, NS, mannitol 20%. Y-site administration: Drug to Drug IV Compatibility: Amikacin, amiodarone, aztreonam, cimetidine, ciprofloxacin, cisatracurium, diltiazem, dopamine, enalapril, epinephrine, esmolol, famotidine, fentanyl, fluconazole, gentamicin, hydromorphone, labetalol, levofloxacin, linezolid, meropenem, methylprednisolone, metoclopramide, milrinone, morphine, nitroglycerin, norepinephrine, ondansetron,…
Adverse Effects
Nausea; hypotension, hypertension (marked increase in systolic blood pressure indicates overdose), arrhythmias, palpitations, chest pain; dyspnoea, bronchospasm; headache; fever; increased urinary urgency; eosinophilia; rash, phlebitis; very rarely myocardial infarction, hypokalaemia; coronary artery spasm and thrombocytopenia also reported.
Risk Factor (Pregnancy/Lactation)
Pregnancy: No evidence of risk in humans. Lactation: Caution advised or effect undetermined. Contraindications: Pheochromocytoma. Precautions: Do not add to alkaline solutions. Acute myocardial infarction; correct hypovolaemia, correct atrial fibrillation with rapid ventricular response with digitalis; peripheral vascular resistance may increase if beta-blocker received recently. Marked mechanical obstruction. Monitor ECG, blood pressure, pulmonary wedge pressure, cardiac output. Safety in children and pregnancy not established. Avoid cyclopropane or halogenated hydrocarbon anaesthetics.
Interactions
General anaesthetics, bretylium, beta-blockers (non-selective ones), guanethidine, MAO inhibitors, methyldopa, reserpine and tricyclic antidepressants, beta-adrenergic blockers.
Advice to Patient
Contact prescriber immediately if there is chest pain, palpitations, rapid heartbeat, headache, nervousness, restlessness, nausea, vomiting or respiratory difficulty. Regular monitoring of haemodynamic parameters, such as central venous pressure, pulmonary artery wedge pressure, and cardiac output is necessary. Urine output is monitored hourly to check renal blood flow.
Pharmacokinetics
Onset of action: IV: 1-10 min. Peak effect: 10-20 min. Metabolism: In tissues as well as hepatic. Half-life elimination: 2 min. Excretion: Urine.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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