What does dobutamine do to the heart?
acetaminophen. Dobutamine is a synthetic catecholamine used to help increase cardiac output in a failing heart due to heart disease or cardiac surgery. Common side effects of dobutamine include increased heart rate, increased blood pressure, irregular ventricular beats, chest pain, fever, headache, nausea, and shortness of breath.
Does dobutamine increase HR?
Dobutamine produces a dose-dependent increase in HR, with low doses (up to 5 mg/kg/min) increasing SV via inotropic effects without significant tachycardia, but doses >10 mg/kg/min produce worsening tachycardia with minimal further increases in CO due to declining SV from decreased diastolic filling time.
Does dobutamine increase BP?
Dobutamine may cause a marked increase in heart rate or blood pressure, especially systolic pressure. Approximately 10% of patients in clinical studies have had rate increases of 30 beats/minute or more, and about 7.5% have had a 50 mm Hg or greater increase in systolic pressure. Usually, reduction of dosage promptly reverses these effects.
Does dobutamine drop BP?
Typically, patients with heart failure treated with intravenous dobutamine have a small increase in systolic blood pressure. We propose that the drop in blood pressure with dobutamine in this patient was caused by a fall in systemic vascular resistance due to vascular beta2-adrenergic receptor activation.
Can dobutamine cause death?
Of the 13 patients who died, 11 patients died while on dobutamine infusion. The causes of death were progressive pump failure in six patients, severe endocarditis with cardiogenic shock or sepsis in five patients, and two patients died of acute graft failure after heart transplantation.
How does dobutamine affect the heart?
Clinically, dobutamine increases cardiac output by selectively augmenting stroke volume, and this is associated with a decrease in total peripheral vascular resistance that is mediated, in part, by reflex withdrawal of sympathetic tone to the vasculature.
Is dobutamine high risk?
General. High Alert Medication: This medication bears a heightened risk of causing significant patient harm when it is used in error.
Can dobutamine cause a stroke?
Dobutamine infusion significantly increased cardiac index, stroke index, and pulmonary capillary wedge pressure, and it decreased systemic vascular resistance.
Does dobutamine have a black box warning?
Warnings. Dobutamine may cause a marked increase in heart rate or blood pressure, especially systolic pressure. Dobutamine may cause a marked increase in heart rate or blood pressure, especially systolic pressure.
How long can you be on dobutamine?
Dobutamine is metabolised rapidly and has a short duration of effect (half-life 2 - 3 minutes)....After termination of infusion, patients must be monitored until stabilised.Very common:≥ 1/10Common:≥ 1/100 to < 1/10Uncommon:≥ 1/1,000 to < 1/1003 more rows
What should I monitor with dobutamine?
Throughout the administration of this medication, there should be continuous monitoring using cardiac monitor and blood pressure checks because dobutamine is typically given to unstable patients and can lead to serious effects quickly that require monitoring and corrective action.
Which is better dopamine or dobutamine?
Dobutamine produced a distinct increase in cardiac index, while lowering left ventricular end-diastolic pressure and leaving mean aortic pressure unchanged. Dopamine also significantly improved cardiac index, but at the expense of a greater increase in heart rate than occurred with dobutamine.
When should dobutamine be used?
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.
How do you reverse dobutamine?
Metoprolol (1 to 5 mg) was available and used intravenously to reverse the effects of dobutamine if they did not revert spontaneously and quickly.
What does dobutamine do to BP?
In responders, dobutamine behaved as an inotrope, increasing blood pressure and cardiac index. In non-responders, dobutamine mainly acted as a vasodilator, since blood pressure decreased, and cardiac index marginally increased.
How does dobutamine make you feel?
The medication will cause your heart to react as if you were exercising: your heart rate will rise and you may feel it beating more strongly. It may cause a warm, flushed feeling, and in some cases, a mild headache.
How does dobutamine increase heart rate?
Dobutamine's ionotropic effect increases contractility, leading to decreased end-systolic volume and, therefore, increased stroke volume. The increase in stroke volume leads to an augmentation of the cardiac output of the heart.
Does dobutamine increase or decrease BP?
Dobutamine may cause a marked increase in heart rate or blood pressure, especially systolic pressure. Approximately 10% of patients in clinical studies have had rate increases of 30 beats/minute or more, and about 7.5% have had a 50 mm Hg or greater increase in systolic pressure.
What does dobutamine do to BP?
In responders, dobutamine behaved as an inotrope, increasing blood pressure and cardiac index. In non-responders, dobutamine mainly acted as a vasodilator, since blood pressure decreased, and cardiac index marginally increased.
Does dobutamine cause bradycardia?
Induction of this reflex increases parasympathetic activity and inhibits sympathetic activity, resulting in bradycardia, which may be accompanied by vasodilation, nausea and hypotension.
For the Consumer
Applies to dobutamine: parenteral concentrate for injection for iv infusion, parenteral injection in 5% dextrose for iv infusion
For Healthcare Professionals
The most common adverse reaction was heart rate increased by 30 beats per minute or more. [ Ref]
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
What is dobutamine injection?
Dobutamine Injection is a catecholamine 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. Dobutamine is available in generic form.
How is dobutamine administered?
Dobutamine is administered in the form of injection. In patients who have atrial fibrillation with rapid ventricular response, a digitalis preparation should be used prior to institution of therapy with dobutamine. Infusion of dobutamine should be started at a low rate (0.5 to 1.0 mcg/kg/min) and titrated at intervals of a few minutes, guided by the patient's response. The rate of infusion of dobutamine needed to increase cardiac output usually ranges from 2.5 to 15 mcg/kg/min.
How much does a heart rate increase with a 10mm increase in systolic blood pressure?
A 10- to 20-mm increase in systolic blood pressure and an increase in heart rate of 5 to 15 beats/minute have been noted in most patients (see WARNINGS regarding exaggerated chronotropic and pressor effects). Approximately 5% of patients have had increased premature ventricular beats during infusions. These effects are dose related.
Does dobutamine interact with beta blockers?
Dobutamine may interact with beta-blockers and nitroprusside. Tell your doctor all medications and supplements you use.
Can dobutamine cause chest pain?
swelling at the injection site. Contact your doctor if you have serious side effects of dobutamine including: low blood pressure, chest pain ( angina ), fast or slow heartbeat, shortness of breath, or. trouble breathing.
Does dobutamine cause blood pressure to drop?
Precipitous decreases in blood pressure have occasionally been described in association with dobutamine therapy. Decreasing the dose or discontinuing the infusion typically results in rapid return of blood pressure to baseline values. In rare cases, however, intervention may be required and reversibility may not be immediate.
Who discovered dobutamine?
In 1975, pharmacologist Tuttle and chemist Mills, discover the compound dobutamine by modifying the structure of isoproterenol/isoprenaline. They published an article "Dobutamine: development of a new catecholamine to selectively increase cardiac contractility"[1]
How is dobutamine administered?
Dobutamine administration is via large intravenous access and infusion pump for inotropic support in decompensated congestive heart failure, stress echocardiogram, and stress nuclear testing. The dosage for cardiac decompensation in heart failure can begin with one-half to one mcg/kg/min and increase up to a maximum of 40 mcg/kg/min. The lower doses of dobutamine can be prescribed at 2.5 to 5.0 mcg/kg/min, and the higher end of dobutamine doses can be 5.0 to 20.0 mcg/kg/min.[9]The dose for the stress echocardiogram and stress nuclear test is initiated at five mcg/kg/min and can be increased in intervals of 10 mcg/kg/min every 3 to 5 minutes until reaching the target heart rate. Dobutamine comes in a solution as a racemic mixture of both positive and negative enantiomers for intravenous administration. The positive enantiomer in the solution is predominately selective for the beta sympathetic receptors, mainly beta 1 and 2, whereas the negative enantiomer has been shown in studies to be selective for the alpha one receptors. [10]
Can dobutamine be given in the short term?
Continuous intravenous inotropic dobutamine support can reasonably be given in the short term for hospitalized patients with severe systolic dysfunction who present with low blood pressure and a significantly decreased cardiac output to preserve systemic blood flow and protect from end-organ damage.
Can dobutamine be used for cardiac shock?
Dobutamine can be used as temporary intravenous inotropic support until resolution of the acute inducing factors or the patient receives more definitive treatment, such as coronary revascularization, mechanical circulatory support, or heart transplant. Short-term intravenous inotropic support should be given to patients in cardiogenic shock to preserve systemic blood flow and protect from end-organ damage.
Is dobutamine safe for short term use?
The FDA approveD dobutamine for short-term use in patients with decreased contractility due to heart failure or cardiac surgical procedures leading to cardiac decompensation. The agent has not been shown to give positive outcomes in the hospitalized or outpatient setting for heart failure patients despite hemodynamically improving the patient's condition. Dobutamine can be used as temporary intravenous inotropic support until resolution of the acute inducing factors or the patient receives more definitive treatment, such as coronary revascularization, mechanical circulatory support, or heart transplant. Short-term intravenous inotropic support should be given to patients in cardiogenic shock to preserve systemic blood flow and protect from end-organ damage. This activity will highlight the mechanism of action, adverse event profile, pharmacology, monitoring, and relevant interactions of dobutamine, pertinent for members of the interprofessional team in treating patients with cardiac disorders that will respond to such therapy.
Can dobutamine be stopped?
Throughout the administration of this medication, there should be continuous monitoring using cardiac monitor and blood pressure checks because dobutamine is typically given to unstable patients and can lead to serious effects quickly that require monitoring and corrective action. The clinician can reduce the dose of dobutamine or stop the medication if the patient experiences adverse effects.
Can you take dobutamine in continuous form?
Patients can reasonably receive dobutamine in continuous intraven ous form for inotropic support to bridge patients with late-stage heart failure, stage D, that is refractory to guideline-directed medical therapy until patients who are candidates for and awaiting cardiac transplantation or mechanical circulatory support receive the appropriate long-term treatment. [3]
What is dobutamine used for?
Dobutamine is a synthetic catecholamine used to help increase cardiac output in a failing heart due to heart disease or cardiac surgery.
What are the symptoms of a heart attack?
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What happens when you stop infusions?
Decreasing the dose or discontinuing the infusion typically results in rapid return of blood pressure to baseline values.
How much does a heart rate increase with a 10mm increase?
A 10- to 20-mm increase in systolic blood pressure and an increase in heart rate of 5 to 15 beats/minute have been noted in most patients.
Can dobutamine cause heart failure?
Dobutamine is a synthetic catecholamine used to help increase cardiac output in a failing heart due to heart disease or cardiac surgery. Common side effects of dobutamine include increased heart rate, increased blood pressure, irregular ventricular beats, chest pain, fever, headache, nausea, and shortness of breath. Available evidence suggests dobutamine may be safely used in pregnancy. Dobutamine should be used cautiously by breastfeeding mothers as it is unknown whether it is excreted in breast milk.
Can you use dobutamine while pregnant?
Available evidence suggests dobutamine may be safely used in pregnancy. Dobutamine should be used cautiously by breastfeeding mothers as it is unknown whether it is excreted in breast milk .
Does dobutamine cause pulmonary wedge pressure?
Preliminary studies indicate that the concomitant use of dobutamine and nitroprusside results in a higher cardiac output and, usually, a lower pulmonary wedge pressure than when either drug is used alone.
What is a dobutamine stress echocardiogram?
A stress echocardiogram is a test done to assess how well the heart works under stress. The “stress” can be triggered by either exercise on a treadmill or a medicine called dobutamine.
How long does dobutamine stay in your system?
Your heart rate, blood pressure, and ECG will continue to be monitored for 10 to 15 minutes until they have returned to the baseline state. Final echocardiogram pictures will be taken.
What is the medication that causes stress?
The “stress” can be triggered by either exercise on a treadmill or a medicine called dobutamine. A dobutamine stress echocardiogram (DSE) may be used if you are unable to exercise. Dobutamine is put in a vein and causes the heart to beat faster. It mimics the effects of exercise on the heart. During an echo, a transducer (like a microphone) ...
How often does dobutamine infusion start?
The dobutamine infusion will begin at a rate determined by your weight. The rate of the infusion will be increased every few minutes until you have reached your target heart rate (determined by the doctor based on your age and physical condition), or until the maximum dose of dobutamine has been reached.
What is a 2D echocardiogram?
2-D (two-dimensional) echocardiogram. This technique is used to see the actual structures and motion of the heart structures. A 2-D echo view looks cone-shaped on the monitor, and the real-time motion of the heart's structures can be seen. This allows the doctor to see the various heart structures at work and evaluate them.
Where to start IV line for dobutamine?
An intravenous (IV) line will be started in your hand or arm before the test. It’s needed for injection of the dobutamine and to give you IV fluids, if needed. You will lie on your left side on a table or bed, but may be asked to change position during the test.
Can beta blockers increase heart rate?
Taking beta-blocking medicines – these may make it hard to increase the heart rate to an appropriate level.
What is dobutamine used for?
Dobutamine is a sympathomimetic amine that was designed as an inotropic agent for use in congestive heart failure. Clinically, dobutamine increases cardiac output by selectively augmenting stroke volume, and this is associated with a decrease in total peripheral vascular resistance that is mediated, in part, by reflex withdrawal ...
Is dobutamine a sympathomimetic amine?
The pharmacology of dobutamine. Dobutamine is a sympathomimetic amine that was designed as an inotropic agent for use in congestive heart failure. Clinically, dobutamine increases cardiac output by selectively augmenting stroke volume, and this is associated with a decrease in total peripheral vascular resistance that is mediated, …. ...
Is dobutamine a hemodynamic drug?
This hemodynamic profile of dobutamine makes the drug of value in the management of low output cardiac failure. The inotropic activity of dobutamine has previously been attributed to selective stimulation of myocardial beta 1-adrenoceptors. However, recent studies from a number of laboratories indicate that the mechanism of action ...
Medical uses
- Dobutamine Injection is a catecholamine 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. Dobutamine is available in generic form. Common side effects of...
Administration
- Dobutamine is administered in the form of injection. In patients who have atrial fibrillation with rapid ventricular response, a digitalis preparation should be used prior to institution of therapy with dobutamine. Infusion of dobutamine should be started at a low rate (0.5 to 1.0 mcg/kg/min) and titrated at intervals of a few minutes, guided by the patient's response. The rate of infusion o…
Treatment
- Precipitous decreases in blood pressure have occasionally been described in association with dobutamine therapy. Decreasing the dose or discontinuing the infusion typically results in rapid return of blood pressure to baseline values. In rare cases, however, intervention may be required and reversibility may not be immediate.
Cause
- Phlebitis has occasionally been reported. Local inflammatory changes have been described following inadvertent infiltration. Isolated cases of cutaneous necrosis (destruction of skin tissue) have been reported.
Adverse effects
- The following adverse effects have been reported in 1% to 3% of patients: nausea, headache, anginal pain, nonspecific chest pain, palpitations, and shortness of breath.
Side effects
- Administration of dobutamine, like other catecholamines, can produce a mild reduction in serum potassium concentration, rarely to hypokalemic levels (see PRECAUTIONS).