DOBUTamine (doe-byoo-ta-meen) Dobutrex

 Indications

Short-term (48 hr) management of heart failure

caused by depressed contractility from organic heart

disease or surgical procedures.

Action

Stimulates beta1(myocardial)-adrenergic receptors

with relatively minor effect on heart rate or peripheral blood vessels. Therapeutic Effects: Increased cardiac

output without significantly increased heart rate.

Pharmacokinetics

Absorption: Administered by IV infusion only, resulting

in complete bioavailability.

Distribution: Unknown.

Metabolism and Excretion: Metabolized by the

liver and other tissues.

Half-life: 2 min.

TIME/ACTION PROFILE (inotropic effects)

ROUTE ONSET PEAK DURATION

IV 1–2 min 10 min brief (min)

Contraindications/Precautions

Contraindicated in: Hypersensitivity to dobutamine

or bisulfites; Idiopathic hypertrophic subaortic

stenosis.

Use Cautiously in: History of hypertension (increased

risk of exaggerated pressor response); MI;

Atrial fibrillation (pretreatment with digitalis glycosides

recommended); History of ventricular atopic activity

(may be exacerbated); Hypovolemia (correct before

administration); Pregnancy or lactation (safety not established).

Adverse Reactions/Side Effects

CNS: headache. Resp: shortness of breath. CV: hypertension,

increased heart rate, premature ventricular

contractions, angina pectoris, arrhythmias, hypotension,

palpitations. GI: nausea, vomiting. Local: phlebitis.

Misc: hypersensitivity reactions including skin

rash, fever, bronchospasm or eosinophilia, nonanginal

chest pain.

Interactions

Drug-Drug: Use with nitroprusside; may have a

synergistic effect onqcardiac output. Beta blockers

may negate the effect of dobutamine.qrisk of arrhythmias

or hypertension with some anesthetics (cyclopropane,

halothane), MAO inhibitors, oxytocics,

or tricyclic antidepressants.

Route/Dosage

IV (Adults and Children): 2.5–15 mcg/kg/min titrate

to response (up to 40 mcg/kg/min).

IV (Neonates): 2–15 mcg/kg/min.

Availability

Injection: 12.5 mg/mL in 20-, 40-, and 100-mL vials.

Premixed infusion: 250 mg/250 mL, 500 mg/500

mL, 500 mg/250 mL, 1000 mg/250 mL.