Dobutamine dosing

Although concern over attenuation of dobutamine s hemodynamic effects with prolonged administration has been raised, some effect is likely retained. Consequently, the dobutamine dose should be tapered rather than abruptly discontinued. 

Start continuous IV infusion at 5-10 mcg/min and titrate using 5-10 mcg/min increments until symptoms resolve or SBP <90 mmHg or MAP falls by >30 mmHg from baseline. Usual maximum dose = 200 mcg/min o Dobutamine—2.5-10 mcg/kg/min continuous IV infusion up to 20 mcg/kg/min... 

If goal not achieved with fluid resuscitation and the hematocrit is >30%, then administer dobutamine continuous IV infusion (maximum dose of 20 mcg/kg/min)... 

Dobutamine is a P-adrenergic inotropic agent that can be utilized for improvement of cardiac output and oxygen delivery. Doses of 2 to 20 mcg/kg per minute increase cardiac index however, heart rate increases significantly. Dobutamine should be considered in septic patients with adequate filling... 

Dobutamine is a /Jj- and / -receptor agonist with some oq-agonist effects. The net vascular effect is usually vasodilation. It has a potent inotropic effect without producing a significant change in heart rate. Initial doses of 2.5 to 5 mcg/kg/min can be increased progressively to 20 mcg/kg/min on the basis of clinical and hemodynamic responses. 

Dopamine should generally be avoided in decompensated HF, but its pharmacologic actions may be preferable to dobutamine or milrinone in patients with marked systemic hypotension or cardiogenic shock in the face of elevated ventricular filling pressures, where dopamine in doses greater than 5 mcg/kg/min may be necessary to raise central aortic pressure. 

DOBUTAMINE HYDROCHLORIDE INJECTION 250MG 20ML SINGLE DOSE VIAL 6505012394660 VI 4.94 ... 

Dopamine stimulates dopaminergic (DAi), and O -adrenoceptors. Accordingly, it is an inotropic agent that may also stimulate the kidney function. In higher doses, dopamine may cause vasoconstriction as a result of i-adrenoceptor stimulation. Dobutamine and dopamine may be combined, although this combination is hardly rational. 

Kim RJ, Manning WJ. Viability assessment by delayed enhancement cardiovascular magnetic resonance will low-dose dobutamine dull the shine Circulation 2004 ... 

Epinephrine [ep ee NEF rin] is one of five catecholamines—epinephrine, norepinephrine, dopamine, dobutamine, and isoproterenol—commonly used in therapy. The first three catecholamines occur naturally, the latter two are synthetic compounds (see Figure 6.7). Epinephrine is synthesized from tyrosine in the adrenal medulla and released, along with small quantities of norepinephrine, into the blood stream. Epinephrine interacts with both a and p receptors. At low doses, p effects (vasodilation) on the vascular system predominate, whereas at high doses, a effects (vasoconstrictor) are strongest. 

Dobutamine (in doses of 2 to 20 nneg/kg/min) is an o-adrenergic inotropic agent that many clinicians prefer for improving cardiac output and oxygen dehvery. Dobutamine should be considered in severely septic patients with adequate filling pressures and blood pressure but low cardiac index. 

DIRECT THEOPHYLLINE Case report of marked tachycardia when dobutamine was given to a patient already taking theophylline Uncertain Carefully titrate the dose of dobutamine in patients taking dobutamine... 

Dose. Usually 2.5 to 10 pg/kg/min of dobutamine hydrochloride, by intravenous infusion. 

In intensive care settings, sympathomimetic catecholamines [e.g., dobutamine, dopamine, epinephrine (adrenaline), isoprenaline (isoproterenol), norepinephrine (noradrenaline, and levarterenol] are often administered via continuous infusion. In clinical practice, reservoirs and administration sets of these drugs are routinely changed every 12 or 24 hours. As the pharmacological efficacy of catecholamines is directly related to their intact phenolic groups, their stability over these dosing periods is questionable. 

Hypotension is common and in addition to the resuscitative measures indicated above, infusion of a combination of dopamine and dobutamine in low dose may be required to maintain renal perfusion. 

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