Dobutamine

Indications

Administration/Absorption

    • IV infusion

Distribution

Dosage

Mechanism

  • Direct-acting inotropic agent whose primary activity results from stimulation of the beta-adrenoceptors of the heart

    • Produces comparatively mild chronotropic, hypertensive, arrhythmogenic, and vasodilative effects

    • Does not cause the release of endogenous norepinephrine, as does dopamine

    • Primary activity results from stimulation of the β1-adrenoceptors of the heart, increasing contractility and cardiac output.

    • Since it does not act on dopamine receptors to induce the release of norepinephrine (another α1 agonist), dobutamine is less prone to induce hypertension than is dopamine.

    • Predominantly a β1-adrenergic agonist, with weak β2 activity, and α1 selective activity

      • used clinically in cases of cardiogenic shock for its β1 inotropic effect in increasing heart contractility and cardiac output.

    • Administered as a racemic mixture consisting of both (+) and (−) isomers

      • the (+) isomer is a potent β1 agonist and α1 antagonist

      • the (−) isomer is an α1agonist.[4]

      • (+)-Dobutamine also has mild β2 agonist activity, which makes it useful as a vasodilator.[5

Excretion

    • Half life 2 minutes

    • In human urine, the major excretion products are the conjugates of dobutamine and 3-O-methyl dobutamine

Side effects

    • Increased risk of arrhythmia, including fatal arrhythmias

    • Hypertension, angina, arrhythmia, and tachycardia

    • Used with caution in atrial fibrillation as it has the effect of increasing the atriovenrticular (AV) conduction

Interactions

Contraindications