Dobutamine: Difference between revisions

(Text replacement - "β1" to "β<sub>1</sub>")
(Text replacement - "-->" to "→")
Line 47: Line 47:
===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)  



Revision as of 22:36, 17 November 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