Dobutamine

A Drug Study Presented to

the Faculty of the Nursing Department
_____________________ RN

In Partial Fulfilment of
the Requirements in NCM 212–RLE
OXYGENTATION/FLUIDS & ELECTROLYTES NURSING ROTATION

By

___________________, St. N
November 15, 2020

Generic Name Dobutamine

Brand Name Dobutrex

Classification Synthetic, Opioids, Opioid Analgesics.

Mode of Action  Enhances myocardial contractility,

 Stimulates beta1 (myocardial)-adrenergic receptors with
relatively minor effect on heart rate or peripheral blood
vessels.
Therapeutic Effect:
 Increased cardiac output without significantly increased
heart rate.

Dose / Route Infusion solution, in D5W

 100mg/100mL
 200mg/100mL
 400mg/100mL
Injectable solution
 12.5mg/mL
Cardiac Decompensation
0.5-1 mcg/kg/min IV continuous infusion initially, then 2-20
mcg/kg/min; not to exceed 40 mcg/kg/min  
Low Cardiac Output (Off-label)
2-20 mcg/kg/min IV or IO; titrate to desired effect; not to exceed 40
mcg/kg/min

Indication Dobutamine injection is indicated when parenteral therapy is

necessary for inotropic support in the short-term treatment of adults
with cardiac decompensation due to depressed contractility
resulting either from organic heart disease or from cardiac surgical
procedures.

In patients who have atrial fibrillation with

rapid ventricular response, a digitalis preparation should be used
 prior to institution of therapy with dobutamine hydrochloride.

Contraindication Contraindicated in:

 Hypersensitivity to dobutamine or bisulfites;
 Idiopathic hypertrophic subaortic stenosis.

Use Cautiously in:

 History of hypertension (↑ risk of exaggerated pressor
response);
 MI;
 Atrial fibrillation (pretreatment with digoxin recommended);
 History of ventricular atopic activity (may be exacerbated);
 Hypovolemia (correct before administration);
 OB:  Safety not established.

Side Effects  Increased Heart Rate, Blood Pressure, and Ventricular

Ectopic Activity
 Hypotension
 Reactions at Sites Of Intravenous Infusion
 Miscellaneous Uncommon Effects

Adverse Effects CNS: headache.

CV: increased heart rate, hypertension, PVCs, angina, nonspecific
chest pain, palpitations, hypotension, ventricular ectopy.
GI: nausea, vomiting.
Respiratory: shortness of breath, asthmatic episodes.
Other: phlebitis, hypersensitivity reactions (anaphylaxis).

Drug Drug-Drug
Interactions  Use with nitroprusside ; may have a synergistic effect on ↑
cardiac output.
  Beta blockers may negate the effect of dobutamine.
 ↑ Risk of arrhythmias or hypertension with some
anaesthetics  (cyclopropane,  halothane ), MAO
inhibitors, oxytocic’s, or  tricyclic antidepressants.
Nursing Assessment
Responsibilities  Continuously monitor BP, heart rate, ECG, pulmonary
capillary wedge pressure (PCWP), cardiac output, CVP, and
urinary output continuously during the administration. Report
significant changes in vital signs or arrhythmias. Consult
physician for parameters for pulse, BP, or ECG changes for
adjusting dose or discontinuing medication.

 Palpate peripheral pulses and assess appearance of

extremities routinely during dobutamine administration.
Notify health care professional if quality of pulse deteriorates
or if extremities become cold or mottled.

Patient/Family Teaching
 Explain to patient the dobutamine and the need for
frequent monitoring.
 Advise patient to inform nurse immediately if chest pain;
dyspnea; or numbness, tingling, or burning of extremities
occurs.
 Instruct patient to notify nurse immediately of pain or
discomfort at the site of administration.
 Home Care Issues: Instruct caregiver on proper care of IV
equipment.
Instruct caregiver to report signs of worsening HF (shortness
of breath, orthopnea, and decreased exercise tolerance),
abdominal pain, and nausea or vomiting to health care
professional promptly.

References:
Davis's Drug Guide. (2020). Dobutamine. Retrieved from
https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Drug-
Guide/51232/all/DOBUTamine
Kozier, R.J., Hodgson, K.J., & EBSCO Publishing. (2019). Dobutamine. Saunders
nursing drug handbook 2019. St. Louis, Missouri: Elsevier.

Kozier, R.J., Hodgson, K.J., & EBSCO Publishing. (2020). Dobutamine. Saunders
nursing drug handbook.