Dobutamine: Difference between revisions
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==General== | ==General== | ||
*Type: [[Vasopressors]] | *Type: [[Vasopressors]] | ||
**Technically an inotrope as beta 2 stimulation causes vasodilation | |||
**Should use in combination with a [[Vasopressors|vasopressor]] (eg [[norepinephrine]]) to avoid hypotension | |||
*Dosage Forms: | *Dosage Forms: | ||
*Common Trade Names: | *Common Trade Names: | ||
==Adult Dosing== | ==Adult Dosing== | ||
===Dosing=== | |||
*2-20mcg/kg/min | |||
**10mcg works for most | |||
*May use in peripheral IV | |||
===Rate of Titration=== | |||
*Q2-5 min | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B | ||
*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 22: | Line 35: | ||
==Adverse Reactions== | ==Adverse Reactions== | ||
*Tachyarrhythmias | |||
*Myocardial ischemia | |||
*[[Hypotension]] as β<sub>2</sub> effect may result in vasodilation | |||
**Caution if SBP <90 | |||
===Serious=== | ===Serious=== | ||
===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: | ||
*Mechanism of Action: | ** Urine as metabolites | ||
*Mechanism of Action:β<sub>1</sub> stimulation with variable BP effects | |||
===Primary Receptor=== | |||
*β<sub>1</sub> | |||
*β<sub>2</sub> | |||
===Relative Effects=== | |||
*↑↑↑SV | |||
*↑↑HR → increases oxygen demand of heart → can worsen ischemia | |||
*↓SVR (transient, from β<sub>2</sub> 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== | ==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== | ||
<references/> | |||
[[Category:Pharmacology]] [[Category:Critical Care]] | |||
[[Category: | |||
Latest revision as of 10:33, 4 January 2022
General
- Type: Vasopressors
- Technically an inotrope as beta 2 stimulation causes vasodilation
- Should use in combination with a vasopressor (eg norepinephrine) to avoid hypotension
- Dosage Forms:
- Common Trade Names:
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: B
- Lactation:
- Unknown if Dobutamine passes into breast milk
- Renal Dosing
- Adult
- Not defined
- Pediatric
- Not defined
- Adult
- Hepatic Dosing
- Adult
- Not defined
- Pediatric
- Not defined
- Adult
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[1]
- 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
References
- ↑ Dobutamine: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.