Dobutamine Uses/Indications Adverse effects-

Classes

DEA Class; Rx

Common Brand Names;

Inotropic Agents

Parenteral direct-acting inotrope
Used for short-term treatment of patients with cardiac decompensation due to depressed contractility from organic heart disease or cardiac surgical procedures
Comparatively mild chronotropic, hypertensive, arrhythmogenic, and vasodilative effects

Indications

Indicated for the short-term inotropic treatment of low output states caused by congestive heart failure, cardiogenic shock, septic shock, or after cardiac surgery.

For use in coronary artery disease diagnosis† (i.e., dobutamine stress echocardiography).

Contraindications

Hypersensitivity to drug or components

Idiopathic hypertrophic subaortic stenosis

Adverse Effects

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%)
Cardiac dysrhythmia
Exacerbation of coronary arteriosclerosis
Hypokalemia
Injection-site reactions
Syncope

Warnings

To optimize hemodynamics, correct hypovolemia if needed

Clinical experience with dobutamine following myocardial infarction has been insufficient to establish safety of drug for this use; there is concern that any agent that increases contractile force and heart rate may increase size of infarction by intensifying ischemia, but not known whether dobutamine does so

Severe coronary artery disease (CAD)

Hypertension common; hypotension may also occur

May cause a marked increase in heart rate or blood pressure,especially systolic pressure; because dobutamine facilitates atrioventricular conduction, patients with atrial fibrillation are at risk of developing rapid ventricular response; in patients who have atrial fibrillation with rapid ventricular response, a digitalis preparation should be used prior to institution of therapy with dobutamine; patients with pre-existing hypertension appear to face an increased risk of developing an exaggerated pressure response

During administration of dobutamine, monitor blood pressure continuously; pulmonary wedge pressure and cardiac output should be monitored whenever possible to aid safe and effective infusion of dobutamine in 5% dextrose Injection, USP

Ventricular ectopy exacerbation may occur

Pregnancy and Lactation

Pregnancy category: B

Lactation: Unknown whether drug is excreted into breast milk; avoid use