Pharmacology – Dobutamine / Dobutrex

Class
Sympathetic agonist

Description
Dobutamine is a synthetic catecholamine

It acts primarily on beta 1 receptors but is a less potent beta agonist than isoproterenol.

Mechanism of Action
Increase the force of the systolic contraction / positive inotropic effect with little chronotropic activity

Useful in the management of CHF when an increase in heart rate is not desired.

Pharmacokinetics
Onset: 2-10 minutes
Peak Effect: 10-20 minutes
Duration: varies
Half life: 2 minutes

Indications
Used for short term management of CHF when an increased cardiac output without an increased cardiac rate is desired.

Contraindications
Should not be used as the sole agent in hypovolemic shock unless fluid resuscitation is well under way

To increase cardiac output in severe emergencies such as cardiogenic shock dopamine is the preferred agent.

Precautions
Tachycardia and an increase in the systolic blood pressure are common

Increases in heart rate of >10% may induce or exacerbate myocardial ischemia

PVC’s can occur

Lidocaine should be readily available.

Side Effects
Nervousness
Headache
Hypertension
Dysrhythmias
Palpitations
Chest Pain
Dyspnea

Interactions
May be ineffective when administered to patients taking beta-blockers.
Patients taking tricyclic antidepressants (TCAs) are at increased risk of hypertension.

Dosage
250 mg diluted in 500 mL or 1 L of D5W

Dosage range is between 2 and 20 mcg/kg/minute

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