DOBUTAMINE
INTRODUCTION
• Dobutamin: Is a beta-1 agonist catecholamine that has cardiac stimulant action
without evoking vasoconstriction or tachycardia.
• It is proposed as a cardiotonic after myocardial infarction or open heart surgery.
Pharmacologic Category
• Dobutamine is Adrenergic Agonist Agent; Inotrope
• it has Strong beta1 and weak beta2/alpha effects, resulting in increased cardiac
output, blood pressure, and heart rate, as well as decreased peripheral vascular
resistance
DOBUTAMINE: MECHANISM OF ACTION
• Dobutamine is a pharmacological agent with ionotropic and chronotropic effects
depending on the dose.
• By binding and activating the β-1 receptors selectively, inotropic effects are
achieved on the myocardium.
• The ionotropic effect of dobutamine enhances contractility, which in turn causes a
decrease in end-systolic volume and an increase in stroke volume.
• The heart's cardiac output is increased by the increase in stroke volume.
INTERACTION
• Concomitant use of Dobutamine & Nitroprussside results in a higher cardiac out
put and lower pulmonary aedge than when either of the drug is used alone
DOBUTAMINE: INDICATIONS
For patients with
• Decompensated congestive heart failure
• Cardiac surgery
• Septicemia
• Myocardial stress testing
CONTRAINDICATIONS
Dobutamine is contraindicated for:
• Patients with ideopatic subaortic stenosis and
• Patients who have previous manifestation of hypersensitivity to dobutamine.
Dobutamine: available dose
• The medication is available as dobutamine hydrochloride 1 mg/mL, 2 mg/mL, and
4 mg/mL in 250 ml and 250 mg/20 mL IV solution.
Dobutamine: Dose & Administration
Adult dose
for patients with Cardiac Decompensation
• 0.5-1 mcg/kg/min IV continuous infusion initially, then 2-20 mcg/kg/min;
not to exceed 20 mcg/kg/min
for patients with Low Cardiac Output (Off-label) as inotropic support
• 2-20 mcg/kg/min IV or IO; titrate to desired effect; not to exceed 20
mcg/kg/min
Pediatric dose
For patients with Decompensated heart failure.
• 0.5-1 mcg/kg/min IV continuous infusion initially, then 2-20 mcg/kg/min;
not to exceed 20 mcg/kg/min
DOBUTAMINE: ADVERSE EFFECT
• Chest pain • Vomiting
• Tachycardia • Tingling sensation
• Paraesthesia
• Angina
• Dyspnea
• Ectopic beats
• Headache
• Palpitations
• Hypersensitivity ( rash, broncospasm and fever)
• Hypertension • Hypokalemia
• Nausia
NURSING INTERVENTION
To optimize hemodynamics, correct hypovolemia if needed.
administer the drug throgh large vein.
During administration of dobutamine, monitor
• Blood pressure continuously;
• Pulmonary wedge pressure and
• Cardiac output should be monitored whenever possible to aid safe and
effective infusion of dobutamine in 5% dextrose injection.
References
• https://www.uptodate.com/contents/dobutamine-drug-information?
sectionName=Adult&topicId=9380&search=dobutamine&usage_type=panel&anchor=F
161962&source=panel_search_result&selectedTitle=1%7E148&showDrugLabel=true&
kp_tab=drug_general&display_rank=1#F161962
• Alhayek S, Preuss CV. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL):
Aug 14, 2023. Beta 1 Receptors.
• Kislitsina ON, Rich JD, Wilcox JE, Pham DT, Churyla A, Vorovich EB, Ghafourian K,
Yancy CW. Shock - Classification and Pathophysiological Principles of Therapeutics.
Curr Cardiol Rev. 2019;15(2):102-113.
• https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/021201s040lbl.pdf
• https://reference.medscape.com/drug/dobutamine-342434#10
