Dobutamine

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: B
  • 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
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