Dobutamine injection is indicated when parenteral therapy is necessary for inotropic support in the short-term treatment of adults with cardiac decompensation due to depressed contractility resulting either from organic heart disease or from cardiac surgical procedures.
Sympathomimetic Agent; Inotrope
Dobutamine Hydrochloride is a direct-acting inotropic agent whose primary activity results from stimulation of cardiac adrenergic receptors; it produces comparatively mild chronotropic, hypertensive, arrhythmogenic and vasodilatory effects. In contrast with dopamine, it does not release norepinephrine and its actions are not dependent on norepinephrine stores in the heart. In humans, Dobutamine Hydrochloride increases stroke volume and cardiac output and decreases ventricular filling pressure and total systemic and pulmonary vascular resistances.
Acute heart failure: Adult: 2.5-10 mcg/ kg, up to 0.5-40 mcg/kg according to patient’s heart rate, cardiac output, BP & urine output. Cardiac stress test: Adult: 5 mcg/kg/min for 8 min using a 1 mg/mI solution, dose is then increased at 5 mcg/kg/min until 20 mcg/ kg/min, w/ each dose being infused for 8 mm before the next increase. Monitor ECG & stop infusion if arrhythmias, marked ST segment depression or other adverse effects occur.
The potency of Dobutamine Hydrochloride may be decreased if the patient is given b-adrenergic receptor antagonists. In such a case, the unopposed a-agonist effects of Dobutamine Hydrochloride may become apparent, including peripheral vasoconstriction and hypertension. Conversely, a-adrenergic blockade may make the b-1 and b-2 effects apparent, resulting in tachycardia and vasodilatation.
There has been no overt indication of medicine interactions in clinical studies in which Dobutamine Hydrochloride was administered concurrently with other medicines, including digitalis preparations, furosemide, spironolactone, lidocaine, nitroglycerin, nitroprusside, isosorbide dinitrate, morphine, atropine, heparin, protamine, potassium chloride, folic acid, and paracetamol.
Hypersensitivity; idiopathic hypertrophic subaortic stenosis (IHSS). Correct hypovolaemia prior to treatment. Increased risk of rapid ventricular response in patients w/ atrial fibrillation. Insufficient data to determine the safety & efficacy of dobutamine use after acute Ml. Elderly. Neonates. Pregnancy.
Increased heart rate & BP, ectopic beats, palpitation. Nausea, headache, chest pain, palpitation, dyspnoea, paraesthesia, leg cramps. Tissue necrosis at site of extravasation. Cardiac arrhythmias, allergy (rare), Ml & hypotension.
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women. This drug should be used during pregnancy only if the benefit outweighs the risk to the fetus and there are no alternatives. Breastfeeding is not recommended during use of this drug.
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
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