dobutamine

Contraindicated in:

Hypersensitivity to dobutamine or bisulfites;
Idiopathic hypertrophic subaortic stenosis.

Use Cautiously in:

Hypertension (↑ risk of exaggerated pressor response);
MI;
Atrial fibrillation;
History of ventricular atopic activity (may be exacerbated);
Hypovolemia (correct before administration);
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding.

Adv. Reactions/Side Effects ⬆ ⬇

CV: hypertension, premature ventricular contractions, tachycardia, angina, arrhythmias, hypotension, palpitations

GI: nausea, vomiting

Local: phlebitis

Neuro: headache

Resp: dyspnea

Misc: hypersensitivity reactions, nonanginal chest pain

Interactions ⬆ ⬇

Drug-drug:

Beta blockers may negate the effect of dobutamine.
↑risk of arrhythmias or hypertension with some anesthetics (cyclopropane, halothane), MAO inhibitors, oxytocics, or tricyclic antidepressants.

Availability ⬆ ⬇

(Generic available)

Solution for injection (requires dilution): 12.5 mg/mL
Premixed infusion: 250 mg/250 mL; 500 mg/250 mL; 1000 mg/250 mL

Route/Dosage ⬆ ⬇

IV (Adults and Children ): 2.5–15 mcg/kg/min; titrate to response (max dose = 40 mcg/kg/min).
IV (Neonates ): 2–15 mcg/kg/min.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Stimulates beta₁(myocardial)-adrenergic receptors to improve cardiac contractility.

Therapeutic effects:

Increased cardiac output.

Classifications ⬆ ⬇

Therapeutic Classification: inotropics

Pharmacologic Classification: adrenergics

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Unknown.

Metabolism/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)

Patient/Family Teaching ⬆ ⬇

Explain the purpose and side effects of dobutamine and the need for frequent monitoring.
Advise patient to inform nurse immediately if chest pain; dyspnea; or numbness, tingling, or burning of extremities occurs.
Instruct patient to notify nurse immediately of pain or discomfort at the site of IV administration.
Advise patient to notify health care provider of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care provider before taking other medications.
Home Care Issues: Instruct caregiver on proper care of IV equipment.
- Instruct caregiver to report signs of worsening HF (shortness of breath, orthopnea, ↓ exercise tolerance), abdominal pain, and nausea or vomiting to health care provider promptly.
Rep: Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected or if breastfeeding.

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Indications ⬇

Contraind./Precautions ⬆ ⬇