Dobutamine adverse effects

Adverse effects Dobutamine should be used with caution in atrial fibrillation, since the drug increases atrioventricular conduction. Other adverse effects are the same as those for epinephrine. Tolerance may develop on prolonged use. 

An Israeh gronp has reviewed the hemodynamic and adverse effects of dobutamine in 400 patients, of whom 187 were aged 65-79 years and 49 were 80 years or older... 

A report from the Mayo Clinic has described 27 elderly patients (mean age 71 years) with aortic stenosis in whom dobutamine stress hemodynamic testing was used to assess the severity of the stenosis (12). There were no severe adverse effects, but relatively minor problems occurred in 16 patients, including chest pain and ventricular extra beats (n = 9 each) and atrial dysrhythmias (n — 4). The authors concluded that the procedure appears to be safe in these high-risk patients, although its diagnostic value may be limited. 

Piloerection, which occurred in 92 (42%) of 218 consecutive patients who underwent dobutamine stress echocardiography, correlated with the age of the patients and was present in 73% of patients aged 50 years or younger [93 ]. Piloerection is a frequent adverse effect of dobutamine infusion, particularly in patients aged 50 years or less, and it occurs most often at a dose of 10 micrograms/kg/minute. It usually precedes the increase in heart rate caused by dobutamine, and is therefore an early and clear indication that the intravenous infusion is working properly. 

Levosimendan treatment has generally been well tolerated in patients with acute HP. One of the most common adverse effects is hypotension which occurred more frequently in the group treated with levosimendan than with placebo. However, this effect was not observed in comparison to dobutamine. Other common adverse events are headache, atrial fibrillation, hypokalaemia, and tachycardia. Levosimendan is associated with a higher incidence of atrial fibrillation however, conflicting results have been presented regarding ventricular arrhythmias. Cardiac failure as an adverse effect was less frequent in the levosimendan-treated group compared to placebo [4]. 

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