Difference between revisions of "Dobutamine"

(Text replacement - "β1" to "β<sub>1</sub>")
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*[[Drug Ratings in Pregnancy|Pregnancy Rating]]:
 
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]:
 
*Lactation:
 
*Lactation:
 +
** Unknown if Dobutamine passes into breast milk
 
*Renal Dosing
 
*Renal Dosing
 
**Adult
 
**Adult
 +
*** Not defined
 
**Pediatric
 
**Pediatric
 +
*** Not defined
 
*Hepatic Dosing
 
*Hepatic Dosing
 
**Adult
 
**Adult
 +
*** Not defined
 
**Pediatric
 
**Pediatric
 +
*** Not defined
  
 
==Contraindications==
 
==Contraindications==
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*Tachyarrhythmias
 
*Tachyarrhythmias
 
*Myocardial ischemia  
 
*Myocardial ischemia  
*[[Hypotension]]as β<sub>2</sub> effect may result in vasodilation
+
*[[Hypotension]] as β<sub>2</sub> effect may result in vasodilation
 
**Caution if SBP <90
 
**Caution if SBP <90
  
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===Common===
 
===Common===
  
==Pharmacology==
+
==Pharmacology,ref>Dobutamine: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019. </ref>==
 
*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===
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===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 β<sub>2</sub> agonism)  
+
*↓SVR (transient, from β<sub>2</sub> agonism)
  
 
==Notes==
 
==Notes==

Revision as of 04:21, 2 May 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,ref>Dobutamine: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019. </ref>

  • 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