Dobutamine

Provider Level

RN/Paramedic

Class

Sympathomimetic, Inotropic Agent

Mechanism of Action

Stimulates beta-1 adrenergic receptors, increasing myocardial contractility and stroke volume with minor beta-2 and alpha-1 effects, resulting in increased cardiac output with minimal changes in heart rate or systemic vascular resistance.

Indications

Cardiogenic shock, congestive heart failure, severe low cardiac output states.

Contraindications

Hypersensitivity, idiopathic hypertrophic subaortic stenosis (IHSS), suspected or known uncorrected hypovolemia, severe tachycardia.

Routes

IV, IO

Onset / Duration

Onset 1 to 2 minutes. Peak effect 10 minutes. Duration 10 to 15 minutes after infusion is stopped.

Adverse Effects

Tachycardia, hypertension, premature ventricular contractions, angina, palpitations, headache, nausea, dyspnea.

Precautions & Interactions

Ensure adequate fluid resuscitation prior to initiation. Monitor ECG, blood pressure, and hemodynamics closely. May exacerbate myocardial ischemia. Use with caution in patients with atrial fibrillation.

Special Considerations

Administer via controlled infusion pump. Incompatible with alkaline solutions like sodium bicarbonate. Half-life is approximately 2 minutes. Does not typically cause significant vasoconstriction compared to dopamine.