Name

dobutamine (Dobutrex®)

Class

Sympathomimetic

Description/Mechanism

Produces inotropic effect by acting on beta receptors and primarily on mycardial alpha receptors. Increases cardiac output and decreases systemic vascular resistance with little or no effect on BP. Also increases conduction through AV node. Has lower potential for precipitating dysrhythmias than dopamine. In CHF, increase in cardiac output enhances renal perfusion and increases sodium excretion and renal output.

Onset

1-2 min; peak after 10 min

Duration

10 – 15 min after cessation of infusion

Indications

Inotropic support in cardiogenic shock

Contraindications

Tachydysrhythmias

Hypertension

Adverse Reactions

Headache

Dose-related tachydysrhythmias

Hypertension

PVCs

angina

Drug Interactions

Beta adrenergic antagonists may blunt inotropic response

Sympathomimetics and phosphodiesterate inhibitors may exacerbate dysrhythmia responses.

Incompatible with sodium bicarbonate and furosemide.

Supplied

10 ml (25mg/ml)

Dose/Administration

Adult

2-20 mcg/kg/min IV, based on inotropic effect.

Pediatric

Same as adult

Special Consideration

Pregnancy Safety: Category C

May be administered through a Y-site with concurrent dopamine, lidocaine, nitroprusside, and potassium chloride infusions.

Blood pressure should be closely monitored.

Increases in heart rate of more than 10% may induce or exacerbate myocardial ischemia.

Lidocaine should be readily available