Drug Index

Dobutamine

 
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Mechanism :

Dobutamine is a direct-acting inotropic agent whose primary activity results from stimulation of the b-receptors of the heart while producing comparatively mild chronotropic, hypertensive, arrhythmogenic, and vasodilative effects. It does not cause the release of endogenous norepinephrine, as does dopamine.


Indication :

• Cardiac failure

• Cardiac surgery

• Septicemia

• Myocardial stress testing


Contraindications :

Dobutamine is contraindicated in patients with idiopathic hypertrophic subaortic stenosis and in patients who have shown previous manifestations of hypersensitivity to dobutamine.


Dosing :

Continuous IV infusion: 2-10 microgram/kg/min increased to a max of 20 microgram/kg/min in newborn and 40 microgram/kg/min in older children if necessary.

Suggested drip administration: 6 x wt (kg) x desired dose (mcg/kg/min)/desired fluid rate (Ml/hr) = mg of dobutamine per 100 ml solution.


Adverse Effect :

Chest pain, tachycardia, angina, ectopic beats, palpitation, hypertension, nausea, vomiting, tingling sensation, paraesthesia, dyspnea, headache, hypersensitivity (rash, fever, bronchospasm), hypokalemia.


Interaction :

Nitroprusside: Concomitant use of dobutamine and nitroprusside results in a higher cardiac output and, a lower pulmonary wedge pressure than when either drug is used alone.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Dose as in normal renal function

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. Dose as in normal renal function
HDNot dialysed. Dose as in normal renal function
HDF/High fluxNot dialysed. Dose as in normal renal function
CAV/VVHDNot dialysed. Dose as in normal renal function

Hepatic Dose :

No dosage adjustments are recommended. Titrate the dobutamine infusion rate as per clinical response.
08/05/2020 08:20:29 Dobutamine
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