| Name: |
DOBUTAMINE (DobutrexR) |
| Classification: |
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
|
| Dose: |
Infusion:
2.5-10 mcg/kg/min |
| Administration: |
IV Infusion
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
|
| Adverse Effects: |
- decreased BP (should not be started in hypotensive patients - increased hypotension at doses > 20 mcg/kg/min or in septic patients)
- tachycardia
- 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)
|
| Drug Interactions: |
- dobutamine + other sympathomimetics = increased risk of toxicity
- dobutamine + theophylline = increased risk of toxicity
- dobutamine + general anaesthetics = arrhythmias
- dobutamine + beta blockers = decreased inotropic effect
|
| Monitoring Therapy: |
- HR, ECG
- BP
- cardiac index
- blood glucose
- PWP
- SVRI, PVRI
- electrolytes
- arterial lactate
- urine output
|
| CCTC Protocol: |
- 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.
|
Print
Handheld
Contrast
