Dobutamine

ADMINISTRATION ROUTES:

IV

ALTERNATIVE NAMES:

Dobutamine

ICU INDICATIONS:

1. Inotrope

PRESENTATION AND ADMINISTRATION:

IV:

Each 20 mL vial contains 250 mg of dobutamine

Add 250 mg of dobutamine (20 mL) to 80 mL of compatible IV fluid (i.e. 250 mg in 100 mL)

Compatible with the following IV fluids:

Normal saline, Glucose and sodium chloride, 5% Dextrose, 10% Dextrose, Hartmanns

Store at room temperature

Protect from light

DOSAGE:

IV:

Rate of 2.5 - 20 mcg/kg/min by infusion

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

Dose as in normal renal function

DOSAGE IN PAEDIATRICS:

IV:

15 mg/kg in 50 mL of 5% dextrose or Normal saline

Administer at 2.5 - 20 mcg/kg/min (0.5 - 4 mL/hr)

(1 mL/hr = 5 mcg/kg/min)

CLINICAL PHARMACOLOGY:

Dobutamine is a direct-acting inotropic agent whose primary activity results from stimulation of the beta2-receptors of the heart while producing comparatively mild chronotropic, hypertensive, arrhythmogenic, and vasodilative effects.

CONTRAINDICATIONS:

1. Idiopathic hypertrophic subaortic stenosis
2. Hypersensitivity to dobutamine

WARNINGS:

Increase in Heart Rate or Blood Pressure:

Dobutamine may cause a marked increase in heart rate or blood pressure, especially systolic pressure

Ectopic Activity:

Dobutamine may precipitate or exacerbate ventricular ectopic activity, but only rarely causes ventricular tachycardia

Hypersensitivity:

Reactions suggestive of hypersensitivity associated with administration of dobutamine in 5% dextrose injection, including skin rash, fever, eosinophilia, and bronchospasm, have been reported occasionally

PRECAUTIONS:

General:

Hypovolemia should be corrected with suitable volume expanders before treatment with dobutamine

Laboratory Tests:

No tests additional to routine ICU tests are indicated

Drug/Laboratory Test Interactions:

None known

IMPORTANT DRUG INTERACTIONS IN ICU:

None of note

ADVERSE REACTIONS:

Cardiovascular system:

Increased heart rate, hypotension, ventricular ectopy, atrial fibrillation, chest pain

Respiratory system:

Shortness of breath

Gastrointestinal system:

Nausea