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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