Difference between revisions of "Dobutamine"

(Text replacement - "β2" to "β<sub>2</sub>")
Line 30: Line 30:
 
*Tachyarrhythmias
 
*Tachyarrhythmias
 
*Myocardial ischemia  
 
*Myocardial ischemia  
*[[Hypotension]]as β2 effect may result in vasodilation
+
*[[Hypotension]]as β<sub>2</sub> effect may result in vasodilation
 
**Caution if SBP <90
 
**Caution if SBP <90
  
Line 44: Line 44:
 
===Primary Receptor===
 
===Primary Receptor===
 
*β1  
 
*β1  
*β2
+
*β<sub>2</sub>
 
===Relative Effects===
 
===Relative Effects===
 
*↑↑↑SV
 
*↑↑↑SV
 
*↑↑HR --> increases oxygen demand of heart --> can worsen ischemia  
 
*↑↑HR --> increases oxygen demand of heart --> can worsen ischemia  
*↓SVR (transient, from β2 agonism)  
+
*↓SVR (transient, from β<sub>2</sub> agonism)  
  
 
==Notes==
 
==Notes==

Revision as of 22:44, 30 July 2017

General

Adult Dosing

Dosing

  • 2-20mcg/kg/min
    • 10mcg works for most
  • May use in peripheral IV

Rate of Titration

  • Q2-5 min

Pediatric Dosing

Special Populations

  • Pregnancy Rating:
  • Lactation:
  • Renal Dosing
    • Adult
    • Pediatric
  • Hepatic Dosing
    • Adult
    • Pediatric

Contraindications

  • Allergy to class/drug

Adverse Reactions

  • Tachyarrhythmias
  • Myocardial ischemia
  • Hypotensionas β2 effect may result in vasodilation
    • Caution if SBP <90

Serious

Common

Pharmacology

  • Half-life:
  • Metabolism:
  • Excretion:
  • Mechanism of Action:β1 stimulation with variable BP effects

Primary Receptor

  • β1
  • β2

Relative Effects

  • ↑↑↑SV
  • ↑↑HR --> increases oxygen demand of heart --> can worsen ischemia
  • ↓SVR (transient, from β2 agonism)

Notes

Indications

  • Cardiogenic shock
    • initial agent in low-output heart failure without requiring BP support
  • Tricyclic overdose
  • septic shock with low cardiac output to improve blood flow

See Also

http://www.atsjournals.org/doi/abs/10.1164/rccm.201006-0972CI?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed#readcube-epdf

References