Difference between revisions of "Dobutamine"

(Special Populations: added)
(Pharmacology: added)
Line 44: Line 44:
 
==Pharmacology==
 
==Pharmacology==
 
*Half-life:  
 
*Half-life:  
 +
** 2 minutes
 
*Metabolism:  
 
*Metabolism:  
 +
** In tissues and hepatically
 
*Excretion:  
 
*Excretion:  
 +
** Urine as metabolites
 
*Mechanism of Action:β<sub>1</sub> stimulation with variable BP effects
 
*Mechanism of Action:β<sub>1</sub> stimulation with variable BP effects
 
===Primary Receptor===
 
===Primary Receptor===
Line 53: Line 56:
 
*↑↑↑SV
 
*↑↑↑SV
 
*↑↑HR → increases oxygen demand of heart → can worsen ischemia  
 
*↑↑HR → increases oxygen demand of heart → can worsen ischemia  
*↓SVR (transient, from β<sub>2</sub> agonism)  
+
*↓SVR (transient, from β<sub>2</sub> agonism)
  
 
==Notes==
 
==Notes==

Revision as of 19:05, 2 April 2019

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:
    • Unknown if Dobutamine passes into breast milk
  • Renal Dosing
    • Adult
      • Not defined
    • Pediatric
      • Not defined
  • Hepatic Dosing
    • Adult
      • Not defined
    • Pediatric
      • Not defined

Contraindications

  • Allergy to class/drug

Adverse Reactions

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

Serious

Common

Pharmacology

  • Half-life:
    • 2 minutes
  • Metabolism:
    • In tissues and hepatically
  • Excretion:
    • Urine as metabolites
  • 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