Dobutamine hydrochloride

AVAILABLE FORMS
Injection:12.5 mg/ml in 20-ml vials (parenteral)

INDICATIONS & DOSAGES

• Increased cardiac output in short term treatment of cardiac decompensation caused by depressed contractility, such as during refractory heart failure; adjunct in cardiac surgery.

ACTION
Directly stimulates beta receptors of heart to increase myocardial contractility and stroke volume. At therapeutic dosages, drug decreases peripheral vascular resistance (afterload), reduces ventricular filling pressure (preload), and may facilitate AV node conduction.Net result is increased cardiac output.
 
ADVERSE REACTIONS
CNS:headache
CV:increased heart rate, hypertention, PVCs, angina, nonspecific chest pain, palpitations, hypotention.
GI:nausea, vomiting
Respiratory:shortness of breath, asthmatic episodes.
Other:phlebitis, hypersensitivity reactions,anaphylaxis.

CONTRAINDICATIONS
Contraindicated in patients hypersensitive to drug or its ingredients and in those with idiopathic hypertrophic subaortic stenosis.

NURSING CONSIDERATIONS

• Use cautiously in patients with history of hypertension. Drug may cause exaggerated pressor response. Also, use cautiously in patients with history of sulfite sensitivity.
• Before starting theraphy with dobutamine, correct hypovolemia with plasma volume expanders.
• Give a cardiac glycoside before dobutamine. Because drug increases AV node conduction, patients with artial fibrillation may develop a rapid ventricular rate.
• Continuously monitor ECG, blood pressure, pulmonary artery wedge pressure, cardiac output and urine output.
• Monitor electrolytes.Drug may lower potassium levels.
• Alert: Don't confuse dobutamnine with dopamine.

PATIENT TEACHING

• Tell patient to report adverse reactions promptly, especially dyspnea and druginduced headache.
• Instruct patient to report discomport at I.V. insection site.