Dobutamine (Dobutrex)

Question 1

Classification

Answer 1

Adrenergic beta-1 agonist; inotropic agent

Question 2

Mechanism of Action

Answer 2

• Increases inatropy (contractility) with little effect on chronotropy (heart rate) or vasculatures.

Question 3

Indications

Answer 3

• Cardiogenic Shock
• CHF

Question 4

Contraindications

Answer 4

• Hypovolemic shock

Question 5

Adverse Effects

Answer 5

• Cardiovascular: palpitations, tachycardia, PVCs, hypertension, chest pain
• Neurological: nervousness, headache
• Other; Leg cramps

Question 6

Administration

Answer 6

• Adult: IVPB: 250 mg in 250 cc D5W or .9% NSS. Run at 2-5 mcg/kg/min, titrate to effect, maximum 20 mcg/kg
• Pediatrics: Same as adult (not recomended for prehospital use)

Question 7

Special Considerations

Answer 7

• Dopamine is the preferred drug for patients with cardiogenic shock
• May have slight beta-2 and/or alpha adrenergic effects
• Adverse hypertension may be potentiated by tricyclic antidepressants