Dobutamine

Dobutamine is used to treat cardiogenic shock and severe heart failure and in certain types of cardiac stress tests. Dobutamine is more effective in the treatment of acute but potentially reversible heart failure, which may occur during cardiac surgery or in cases of septic or cardiogenic shock. Dobutamine can also be used in congestive heart failure to improve cardiac output. Dobutamine is specifically for parenteral therapy when it is necessary for inotropic support in the short-term treatment of cardiac decompensation resulting from depressed contractility. This depressed contractility is caused by organic heart disease or surgical cardiac procedures. However, it is not useful in treating ischemic heart disease. It improves heart rate, eventually resulting in the improvement of myocardial oxygen demand. It is also used in hospitals as a pharmacologic stress testing agent in the identification of coronary artery disease. Dobutamine is sold under the brand names like Dobutrex and Inotrex amongst others Eli Lilly scientists, Drs. Ronald Tuttle and Jack Mills, first developed it in the 1970s, as a structural analog of isoprenaline. Dobutamine received FDA approval for medical use in the United States in 1978. It is a generic medication and made from isoproterenol.

Dosage and administration

Dobutamine is available as an injection of 12.5 mg/mL. Each 20 mL Single-Dose Vials has 250 mg of dobutamine hydrochloride or 40 mL Single-Dose Vials which have 500 mg of Dobutamine hydrochloride. It is injected into the vein as a continuous infusion and the amount of medication needed is adjusted for the desired effect. It acts quickly and the onset of action can be felt within 2 minutes. For preparing the injection, Dilute the 20 mL vial in an IV container in at least 50 mL of diluent and dilute 40 mL in at least 100 mL of diluent. The intravenous solutions are diluted with Dextrose Injection 5%, Dextrose 5%, and Sodium Chloride 0.9% Injection, Dextrose Injection 10%, Lactated Ringer's Injection, 5% Dextrose in Lactated Ringer's Injection, in Water for Injection. The infusion of dosage recommended for cardiac output improvement is between 2.5 to 15 mcg per kilo per minute. This can be raised to 40mcg is the desired effect is not achieved at the regular dose.

The cost of Dobutamine

In the UAS, the consumer pay around $92 for a supply of 3000 milliliters of Dobutamine intravenous solution 1 mg/mL-D5%. This medicine is more affordable in the developing world. In India, the consumer pay around $2 for a supply of 5 vials of 5ml totaling 250mg milliliters of Dobutamine intravenous solution 1 mg/mL-D5%.

How does Dobutamine Work?

Dobutamine is a direct-acting inotropic agent. Its primary actions caused by stimulating beta- adrenoceptors in the heart where it creates relatively mild chronotropic, hypertensive, arrhythmogenic, and vasodilative effects. Dobutamine targets beta-1 adrenergic receptors while having negligible effects on beta-2 receptors. Unlike dopamine, It does not release endogenous norepinephrine. Dobutamine actions by stimulating the beta-1 receptors, increase myocardial contractility, and stroke volume. The final result is an increased cardiac output.

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