||sympathomimetic; inotropic agent
- synthetic derivative of isoproterenol; decreases afterload
- stimulates beta1 adrenergic receptors to increase myocardial contractility
- alpha adrenergic receptors increase blood pressure at low dose
2.5-10 mcg/kg/min (start at low dose and titrate to target cardiac index, venous oxygen saturation or other indicator of cardiac output)
500 mg/250 mL D5W, NS, RL
- Protect from light
- May turn pink in solution without affecting potency
- Hypovolemia, acidosis and hypoxemia should be corrected concurrently with therapy
- Should be weaned off
- decreased BP (should not be started in hypotensive patients - increased hypotension at doses > 20 mcg/kg/min or in septic patients)
- increased BP (associated with low doses)
- arrhythmias (usually PVC)
- increased blood glucose
- extravasation of drug may cause tissue necrosis (may be Rx with 5-15 mg phentolamine in NS - see phentolamine monograph)
- dobutamine + other sympathomimetics = increased risk of toxicity
- dobutamine + theophylline = increased risk of toxicity
- dobutamine + general anaesthetics = arrhythmias
- dobutamine + beta blockers = decreased inotropic effect
- HR, ECG
- cardiac index
- blood glucose
- SVRI, PVRI
- arterial lactate
- urine output
- May be administered by IV infusion by an approved nurse in CCTC.
- May be titrated by an approved nurse in CCTC.
- Must be administered via central line.
- Continuous infusion must be administered via an infusion pump.
- Should not be infused through the proximal injectate port (blue) of the Swan Ganz catheter.
- Patient requires placement of an arterial line to monitor BP.