Dobutin

Introduction
Dobutin is a medicine used for short-term treatment of cardiac decompensation (low blood pressure due to poorly functioning heart) due to disease like heart failure, cardiogenic shock, or heart attack. It increases the blood pressure by increasing the pumping capacity of the heart. Dobutin is also used while performing stress echocardiography evaluation of the heart. It is administered under the supervision of a doctor as it requires continuous blood pressure monitoring. The dose has to be individually adjusted as per the patient’s response to therapy. You should continue all your other medicines that are advised by the doctor for your long-term treatment even after this injection. Your doctor may advise for regular monitoring of blood pressure. It may cause side effects like high blood pressure and insomnia (difficulty in sleeping). You must inform the doctor if you are suffering from any liver or kidney disease. Also, let your doctor know about all the other medications that you are using regularly.

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Uses of Dobutin
Heart failure
Low blood pressure
Side effects of Dobutin
Common
High blood pressure
Insomnia (difficulty in sleeping)
How to use Dobutin
Your doctor or nurse will give you this medicine. Kindly do not self administer.
How Dobutin works
Dobutin is a sympathomimetic agonist. It works by activating the receptors in the heart. This makes the heart pump blood with more strength and force and increases its pumping capacity in conditions such as heart failure.
What if you forget to take Dobutin?
If you miss a dose of Dobutin, please consult your doctor.
Quick Tips
It is given into the vein as a drip by a healthcare professional.
Your doctor may perform regular blood tests to monitor the level of sodium and potassium in the blood.
Inform your doctor if you are pregnant, planning pregnancy or breastfeeding.
Brief Description
Indication
Heart failure, Cardiac stress test
Administration
IV Preparation Solution: Dilute 250 mg in 250 mL of compatible solution to yield final concentration of 1000 mcg/mL; not to exceed 5000 mcg/mL The rate of administration and the duration of therapy should be adjusted according to the patient’s response, The indicators are: haemodynamic parameters such as heart rate and rhythm, arterial pressure, and, whenever possible, cardiac output and measurements of ventricular filling pressures and signs of pulmonary congestion. Because of its short half-life, Dobutamine Hydrochloride must be administered as a continuous intravenous infusion. Following the initiation of a constant rate infusion, or upon changing the rate, a steady-state dobutamine plasma concentration is achieved within approximately 10 minutes. Thus, loading doses or bolus injections are not necessary and are not recommended.

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Adult Dose
Cardiac Decompensation 0.5-1 mcg/kg/min IV continuous infusion initially, then 2-20 mcg/kg/min; not to exceed 40 mcg/kg/min Adjust according to patient’s BP, heart rate, cardiac and urine output.

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Child Dose
Cardiac Decompensation 0.5-1 mcg/kg/min IV continuous infusion initially, then 2-20 mcg/kg/min; not to exceed 40 mcg/kg/min

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Contraindication
Hypersensitivity; idiopathic hypertrophic subaortic stenosis (IHSS).
Mode of Action
Dobutamine increases contractility and heart rate by stimulating ?-adrenergic receptors in the cardiac tissues.
Precaution
Correct hypovolaemia prior to treatment. Increased risk of rapid ventricular response in patients with atrial fibrillation. Insufficient data to determine the safety and efficacy of dobutamine use after acute MI. Elderly. Neonates. Pregnancy. Lactation: Unknown whether drug is excreted into breast milk; avoid use

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Side Effect
1-10% Tachyarrhythmia (10%),Hypertension (7.5%),Eosinophilic myocarditis (<7%),Premature ventricular beats (5%; dose related),Angina (1-3%),Dyspnea (1-3%),Fever (1-3%),Headache (1-3%),Nausea (1-3%),Palpation (1-3%) Frequency Not Defined Cardiac dysrhythmia,Exacerbation of coronary arteriosclerosis,Hypokalemia,Injection-site reactions,Syncope,10- to 20-mm Hg increase in systolic blood pressure and increase in heart rate of 5 to 15 beats/min Potentially Fatal: Cardiac arrhythmias, allergy (rare), MI and hypotension. _ Pregnancy Category Note Pregnancy category: B Lactation: Unknown whether drug is excreted into breast milk; avoid use _ Interaction Increased cardiac output when used with nitroprusside. Increased vasopressor effect of dobutamine when used with bretylium, guanethidine, oxytocic drugs or TCAs.