What is the effect of dobutamine on heart rate?
In healthy animals, dobutamine primarily increases stroke volume and cardiac output because of its inotropic effects. There is also a small increase in heart rate that is a minor contribution to the increase in cardiac output.
Why does dobutamine decrease heart rate?
In contrast to epinephrine or dopamine, dobutamine generally reduces systemic vascular resistance (SVR) by a combination of direct vasodilation and a reflex decrease in sympathetic vascular tone. This might be offset by the increase in cardiac output, leading to no change or a decrease in mean arterial pressure.
What effect does dobutamine produce?
In clinical use, dobutamine has a rapid onset of action and a short half-life. It increases myocardial contractility, while the reflex reduction in sympathetic tone, in response to augmentation of stroke volume, leads to a decrease in total peripheral resistance.
Does dobutamine increase or decrease BP?
The hemodynamic response to dobutamine generally involves a modest increase in systolic blood pressure with a modest decrease in diastolic blood pressure through doses up to 20 µg/kg/min, with only small further changes after that point.
Why do we give dobutamine?
Dobutamine is indicated for patients who require positive inotropic support in the treatment of cardiac decompensation due to depressed contractility resulting either from organic heart disease or from cardiac surgical procedures, especially when a low cardiac output is associated with raised pulmonary capillary ...
Does dobutamine cause atrial fibrillation?
Results: There was a 2% incidence of dobutamine stress echocardiography-induced atrial fibrillation in the study population.
Is dobutamine a high risk medication?
General. High Alert Medication: This medication bears a heightened risk of causing significant patient harm when it is used in error.
Which of the following is most likely a side effect associated with dobutamine?
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. Isolated cases of thrombocytopenia have been reported.
Why is dobutamine in cardiogenic shock?
Dobutamine is a catecholamine with β-1 and β-2 adrenergic agonist properties which help improve myocardial contractility. In patients with cardiogenic shock due to decompensated heart failure, dobutamine decreases left ventricular end-diastolic pressure and raises blood pressure by increasing cardiac output.
Is dobutamine used for hypotension?
Dobutamine and dopamine are catecholamines used to treat low blood pressure (hypotension), low cardiac output, and reduced perfusion of body organs due to shock, trauma, and sepsis.
Which is better dopamine or dobutamine?
Unlike dopamine, dobutamine does not have any effect on the α2‐adrenergic receptors. Dobutamine is preferred when there is a need to improve low cardiac output. Dobutamine should be avoided in patients affected by outflow obstructions, pulmonic stenosis, or hypertrophic obstructive cardiomyopathy.
Does dopamine affect heart rate?
Dopamine increased pulse pressure, heart rate and circulating epinephrine (E) and norepinephrine (NE) levels. Dopamine agonists tend to diminish blood pressure by inhibiting sympathetic neuronal discharge of NE and, to a lesser extent, by stimulating dopamine vascular receptors.
Why dobutamine is preferred over dopamine in cardiogenic shock?
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.
Does dobutamine have chronotropic effect?
Dobutamine is a synthetic catecholamine with a strong affinity for both β1- and β2-receptors, which it binds to at a 3:1 ratio (Table; Figure 3B). With its cardiac β1-stimulatory effects, dobutamine is a potent inotrope, with weaker chronotropic activity.
Is dobutamine a potent vasoconstrictor?
Sure, as a mediator of arterial vasodilation, dobutamine has a potent vasodilating effect on the coronary arteries as well, and it is known that it causes a significant increase in coronary blood flow for people with healthy coronary arteries.
Why is dobutamine used in congestive heart failure?from en.wikipedia.org
Dobutamine can be used in cases of congestive heart failure to increase cardiac output. It is indicated when parenteral therapy is necessary for inotropic support in the short-term treatment of patients with cardiac decompensation due to depressed contractility, which could be the result of either organic heart disease or cardiac surgical procedures. Higher doses are not useful with history of recent ischemic heart disease because it increases heart rate and thus increases myocardial oxygen demand.
What is dobutamine?from drugs.com
Dobutamine stimulates heart muscle and improves blood flow by helping the heart pump better.
What should I avoid while using dobutamine?from drugs.com
Follow your doctor's instructions about any restrictions on food, beverages, or activity.
What are the symptoms of dobutamine?from drugs.com
The symptoms of toxicity may include anorexia, nausea, vomiting, tremor, anxiety, palpitations, headache, shortness of breath, and anginal and nonspecific chest pain. The positive inotropic and chronotropic effects of Dobutamine on the myocardium may cause hypertension, tachyarrhythmias, myocardial ischemia, and ventricular fibrillation. Hypotension may result from vasodilation.
How much dobutamine injections need to be diluted?from drugs.com
Preparation and Stability − At the time of administration, Dobutamine Injection, USP must be further diluted in an intravenous container to at least a 50 mL solution using one of the following intravenous solutions as a diluent: 5% Dextrose Injection, USP; 5% Dextrose and 0.45% Sodium Chloride Injection, USP; 5% Dextrose and 0.9% Sodium Chloride Injection, USP; 10% Dextrose Injection, USP; Isolyte ® M with 5% Dextrose Injection; Lactated Ringer's Injection; 5% Dextrose in Lactated Ringer's Injection; Normosol ® -M in D5-W; 20% Osmitrol ® in Water for Injection; 0.9% Sodium Chloride Injection, USP; or Sodium Lactate Injection, USP. Intravenous solutions should be used within 24 hours.
What are the initial steps to take in a dobutamine overdose?from drugs.com
The initial actions to be taken in a Dobutamine overdose are discontinuing administration, establishing an airway, and ensuring oxygenation and ventilation. Resuscitative measures should be initiated promptly. Severe ventricular tachyarrhythmias may be successfully treated with propranolol or lidocaine. Hypertension usually responds to a reduction in dose or discontinuation of therapy.
How much does a heart rate increase during a ventricular infusion?from drugs.com
Increased Heart Rate, Blood Pressure, and Ventricular Ectopic Activity − 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.
What are the side effects of dobutamine?from drugs.com
Get medical help right away, if you have any of the symptoms listed above. The most common side effects of Dobutamine include: increased heart rate, increased blood pressure, ventricular ectopic activity, nervousness, headache,
Why is dobutamine hydrochloride toxic?from rxlist.com
Toxicity from dobutamine hydrochloride is usually due to excessive cardiac β- receptor stimulation. The duration of action of dobutamine hydrochloride is generally short (T½= 2 minutes) because it is rapidly metabolized by catechol-0-methyltransferase. The symptoms of toxicity may include anorexia, nausea, vomiting, tremor, anxiety, palpitations, headache, shortness of breath, and anginal and nonspecific chest pain. The positive inotropic and chronotropic effects of dobutamine on the myocardium may cause hypertension, tachyarrhythmias, myocardial ischemia, and ventricular fibrillation . Hypotension may result from vasodilation.
What is dobutamine?from drugs.com
Dobutamine stimulates heart muscle and improves blood flow by helping the heart pump better.
What should I avoid while using dobutamine?from drugs.com
Follow your doctor's instructions about any restrictions on food, beverages, or activity.
What are the initial actions to be taken in a dobutamine hydrochloride overdose?from rxlist.com
The initial actions to be taken in a dobutamine hydrochloride overdose are discontinuing administration, establishing an airway, and ensuring oxygenation and ventilation. Resuscitative measures should be initiated promptly. Severe ventricular tachyarrhythmias may be successfully treated with propranolol or lidocaine. Hypertension usually responds to a reduction in dose or discontinuation of therapy.
How is dobutamine administered?from rxlist.com
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]
How long does dobutamine stay in your system?from rxlist.com
Most clinical experience with dobutamine is short-term-not more than several hours in duration. In the limited number of patients who were studied for 24, 48, and 72 hours, a persistent increase in cardiac output occurred in some, whereas output returned toward baseline values in others.
Why is dobutamine used in congestive heart failure?from en.wikipedia.org
Dobutamine can be used in cases of congestive heart failure to increase cardiac output. It is indicated when parenteral therapy is necessary for inotropic support in the short-term treatment of patients with cardiac decompensation due to depressed contractility, which could be the result of either organic heart disease or cardiac surgical procedures. Higher doses are not useful with history of recent ischemic heart disease because it increases heart rate and thus increases myocardial oxygen demand.
What is dobutamine?from drugs.com
Dobutamine stimulates heart muscle and improves blood flow by helping the heart pump better.
What should I avoid while using dobutamine?from drugs.com
Follow your doctor's instructions about any restrictions on food, beverages, or activity.
How is dobutamine administered?from ncbi.nlm.nih.gov
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]
How long does dobutamine last?from en.wikipedia.org
It is given by IV only, as an injection into a vein or intraosseous as a continuous infusion. The amount of medication needs to be adjusted to the desired effect. Onset of effects is generally seen within 2 minutes. It has a half-life of two minutes.
Can dobutamine be given in the short term?from ncbi.nlm.nih.gov
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?from ncbi.nlm.nih.gov
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.
