Dobutamine: Difference between revisions

(Text replacement - "β1" to "β<sub>1</sub>")
No edit summary
(5 intermediate revisions by 3 users not shown)
Line 17: Line 17:
*[[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==
Line 30: Line 35:
*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


Line 37: Line 42:
===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===
Line 47: Line 55:
===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