Drug Action
Dobutamine is a cardiac stimulant which acts on beta1 receptors in cardiac muscle, and increases contractility.
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Drug reference
Dobutamine is a cardiac stimulant which acts on beta1 receptors in cardiac muscle, and increases contractility.
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Inotropic support in infarction, cardiac surgery, cardiomyopathies, septic shock, cardiogenic shock, and during positive end expiratory pressure ventilation ▶BY INTRAVENOUS INFUSION ▶Adult: Usual dose 2.5–10 micrograms/kg/minute, adjusted according to response, alternatively 0.5–40 micrograms/kg/minute Cardiac stress testing ▶BY INTRAVENOUS INFUSION ▶Adult: (consult product literature)
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Phaeochromocytoma
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Acute heart failure. acute myocardial infarction . arrhythmias. correct hypercapnia before starting and during treatment. correct hypovolaemia before starting and during treatment. correct hypoxia before starting and during treatment. correct metabolic acidosis before starting and during treatment. diabetes mellitus. elderly. extravasation may cause tissue necrosis. extreme caution or avoid in marked obstruction of cardiac ejection (such as idiopathic hypertrophic subaortic stenosis). hyperthyroidism. ischaemic heart disease. occlusive vascular disease. severe hypotension. susceptibility to angle-closure glaucoma. tachycardia. tolerance may develop with continuous infusions longer than 72 hours
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→Appendix 1: sympathomimetics, inotropic
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▶Common or very common Arrhythmias. bronchospasm. chest pain. dyspnoea. eosinophilia. fever. headache. inflammation localised. ischaemic heart disease. nausea. palpitations. platelet aggregation inhibition (on prolonged administration). skin reactions. urinary urgency. vasoconstriction ▶Uncommon Myocardial infarction ▶Rare or very rare Atrioventricular block. cardiac arrest. coronary vasospasm. hypertension exacerbated. hypokalaemia. hypotension exacerbated ▶Frequency not known Anxiety. cardiomyopathy. feeling hot. myoclonus. paraesthesia. tremor
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No evidence of harm in animal studies— manufacturers advise use only if potential benefit outweighs risk.
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Manufacturers advise avoid—no information available.
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Monitor serum-potassium concentration.
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Dobutamine injection should be diluted before use or given undiluted with Cardiovascular system syringe pump. Dobutamine concentrate for intravenous infusion should be diluted before use. For intravenous infusion, give continuously in Glucose 5% or Sodium chloride 0.9%. Dilute to a concentration of 0.5–1 mg/mL and give via an infusion pump; give higher concentration (max. 5 mg/mL) through central venous catheter; incompatible with bicarbonate and other strong alkaline solutions.
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There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: solution for infusion Solution for infusion EXCIPIENTS: May contain Sulfites ▶Dobutamine (Non-proprietary) Dobutamine (as Dobutamine hydrochloride) 5 mg per 1 ml Dobutamine 250mg/50ml solution for infusion vials | 1 vial P £7.50 Dobutamine (as Dobutamine hydrochloride) 12.5 mg per 1 ml Dobutamine 250mg/20ml concentrate for solution for infusion ampoules | 5 ampoule P £12.00–£29.25 | 10 ampoule P £52.50 8.1a Cardiac arrest Cardiopulmonary resuscitation Overview The algorithm for cardiopulmonary resuscitation (Life support algorithm (image), inside back pages) reflects the most recent recommendations of the Resuscitation Council (UK); this has been reproduced with the kind permission of the Resuscitation Council (UK). The guidelines are available at www.resus.org.uk. Cardiac arrest can be associated with ventricular fibrillation, pulseless ventricular tachycardia, asystole, and pulseless electrical activity (electromechanical dissociation). Adrenaline/epinephrine below 1 in 10000 (100 micrograms/mL) is recommended by intravenous injection repeated every 3–5 minutes if necessary. Administration through a central line results in a faster response than peripheral administration, however placement of a central line must not interfere with chest compressions; drugs administered peripherally must be followed by a flush of at least 20 mL Sodium Chloride 0.9% injection to aid entry into the central circulation. Intravenous injection of amiodarone hydrochloride p. 112 should be considered after adrenaline/epinephrine to treat ventricular fibrillation or pulseless ventricular tachycardia in cardiac arrest refractory to defibrillation. An additional dose of amiodarone hydrochloride can be given if necessary, followed by an intravenous infusion of amiodarone hydrochloride. Lidocaine hydrochloride p. 109, is an alternative if amiodarone hydrochloride is not available. Atropine sulfate p. 1404 is no longer recommended in the treatment of asystole or pulseless electrical activity. During cardiopulmonary arrest if intravenous access cannot be obtained, the intraosseous route can be used instead. Drug administration via the endotracheal route is no longer recommended. For the management of acute anaphylaxis, see allergic emergencies under Antihistamines, allergen immunotherapy and allergic emergencies p. 291. SYMPATHOMIMETICS › VASOCONSTRICTOR
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Usual dose 2.5–10 micrograms/kg/minute,
First-line fragment. Read the complete Indications and Dose section above.
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(consult product literature)
First-line fragment. Read the complete Indications and Dose section above.
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