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10 Cards in this Set

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What is the best-known trade name for dobutamine?
Dobutrex
Another brand name is Inotrex.
What is the functional class of dobutamine?
Sympathomimetic
Dobutamine is a structural analogue of isoprenaline (Isuprel), another sympathomimetic.
What is the mechanism of action of dobutamine?
Synthetic catecholamine which acts primarily on Beta-1 and alpha-adrenergic receptors. Balanced by Beta-2 receptors, it increases cardiac output via increased inotropic effects and decreases pulmonary wedge pressure (PWP) with little or no effect on BP or heart rate. Dobutamine also increases conduction through the AV node.
Dobutamine does not act on dopamine receptors to induce the release of norepinephrine (another α1 agonist) so is less likely to induce hypertension.
What are the listed indications for dobutamine?
- Short term management of CHF or cardiogenic shock
- Used to increase cardiac output without increasing rate
Dobutamine is also commonly used in the hospital setting as a pharmacologic stress testing agent to identify coronary artery disease.
What are the listed contraindications for dobutamine?
- Hypersensitivity
- VT
Some sources include obstructive hypertrophic cardiomyopathy, also known as hypertrophic obstructive cardiomyopathy (HOCM), idiopathic hypertrophic subaortic stenosis (IHSS) and asymmetric septal hypertrophy (ASH).
What are the listed precautions for dobutamine?
- Can increase myocardial oxygen demand
- Can be deactivated by sodium bicarbonate
- Preexisting HTN or A-Fib
- Hypotension from hypovolemia; always try volume restoration first
Caution should also be used in patients with a sensitivity to sulfites.
What are the listed side effects for dobutamine?
- Tachycardia
- HTN
- Dyspnea
- Dysrhythmias
- Palpitations
- Chest pain
- Headaches
- Anxiety
- N/V
Studies suggest that while this medication can improve symptoms in chronic CHF, it actually shortens a patient's lifespan.
What are the listed interactions for dobutamine?
- Absolute interaction with beta-blockers as they decrease
dobutamine’s effectiveness.
- Use with extreme caution with tricyclic
antidepressants
Some sources state that significant adverse affects can occur if dobutamine is used with stimulants, especially cocaine.
What is the dosage and route of dobutamine?
2-20mcg/kg/min IV infusion

Mix 250mg in 250mL (or 500mg in 500mL) D5W or NS,
which yields 1000mcg/mL
Dobutamine has been infused for up to 72 hours without decreased effectiveness.
What is preferred to dobutamine in cases of cardiogenic shock?
Dopamine
Dobutamine may be useful as an adjunct to volume replacement in patients with right ventricular infarction, since dopamine may increase pulmonary vascular resistance.