Uses of Dobutin: - Heart failure - Low blood pressure Heart failure, Cardiac stress test Hypersensitivity; idiopathic hypertrophic subaortic stenosis (IHSS).

Inotropic-sympathomimetics

Dobutamine exerts positive inotropic effect on the myocardium by stimulating β1-adrenergic receptors, thereby increasing myocardial contractility, stroke vol and cardiac output.

How to use Dobutamine: Your doctor or nurse will give you this medicine. Kindly do not self administer. Administration: IV Preparation Solution: Dilute 250 mg in 250 mL of compatible solution to yield final concentration of 1000 mcg/mL; not to exceed 5000 mcg/mL The rate of administration and the duration of therapy should be adjusted according to the patient's response, The indicators are: haemodynamic parameters such as heart rate and rhythm, arterial pressure, and, whenever possible, cardiac output and measurements of ventricular filling pressures and signs of pulmonary congestion. Because of its short half-life, Dobutamine Hydrochloride must be administered as a continuous intravenous infusion. Following the initiation of a constant rate infusion, or upon changing the rate, a steady-state dobutamine plasma concentration is achieved within approximately 10 minutes. Thus, loading doses or bolus injections are not necessary and are not recommended. Adult Dose: 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 Adjust according to patient's BP, heart rate, cardiac and urine output. Child Dose: 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

Increased cardiac output when used with nitroprusside. Increased vasopressor effect of dobutamine when used with bretylium, guanethidine, oxytocic drugs or TCAs.

Hypersensitivity; idiopathic hypertrophic subaortic stenosis (IHSS).

Common - High blood pressure - Insomnia (difficulty in sleeping) 1-10% Tachyarrhythmia (10%),Hypertension (7.5%),Eosinophilic myocarditis (<7%),Premature ventricular beats (5%; dose related),Angina (1-3%),Dyspnea (1-3%),Fever (1-3%),Headache (1-3%),Nausea (1-3%),Palpation (1-3%) Frequency Not Defined Cardiac dysrhythmia,Exacerbation of coronary arteriosclerosis,Hypokalemia,Injection-site reactions,Syncope,10- to 20-mm Hg increase in systolic blood pressure and increase in heart rate of 5 to 15 beats/min Potentially Fatal: Cardiac arrhythmias, allergy (rare), MI and hypotension.

Since there are no adequate and well controlled studies in pregnant women, Dobutamine Hydrochloride should not be used during pregnancy unless the potential benefits outweigh the potential risks to the foetus.It is not known whether this medicine is excreted in human milk. Because many medicines are excreted in human milk, caution should be exercised when Dobutamine Hydrochloride is administered to a nursing woman. If a mother requires dobutamine treatment, breastfeeding should be discontinued for the duration of the treatment.

Precaution: Correct hypovolaemia prior to treatment. Increased risk of rapid ventricular response in patients with atrial fibrillation. Insufficient data to determine the safety and efficacy of dobutamine use after acute MI. Elderly. Neonates. Pregnancy. Lactation: Unknown whether drug is excreted into breast milk; avoid use

Signs And Symptoms: Toxicity from dobutamine hydrochloride is usually due to excessive cardiac β- receptor stimulation. The duration of action of dobutamine hydrochloride is generally short (T½= 2 minutes) because it is rapidly metabolized by catechol-0-methyltransferase. The symptoms of toxicity may include anorexia, nausea, vomiting, tremor, anxiety, palpitations, headache, shortness of breath, and anginal and nonspecific chest pain. The positive inotropicand chronotropic effects of dobutamine on the myocardium may cause hypertension, tachyarrhythmias, myocardial ischemia, and ventricular fibrillation. Hypotension may result from vasodilation.Treatment: To obtain up-to-date information about the treatment of overdose, a good resource is your certified Regional Poison Control Center. Telephone numbers of certified poison control centers are listed in the Physicians' Desk Reference (PDR). In managing overdosage, consider the possibility of multiple drug overdoses, interaction among drugs, and unusual drug kinetics in your patient.The initial actions to be taken in a dobutamine hydrochloride overdose are discontinuing administration, establishing an airway, and ensuring oxygenation and ventilation. Resuscitative measures should be initiated promptly. Severe ventricular tachyarrhythmias may be successfully treated with propranolol or lidocaine. Hypertension usually responds to a reduction in dose or discontinuation of therapy.Protect the patient's airway and support ventilation and perfusion. If needed, meticulously monitor and maintain, within acceptable limits, the patient's vital signs, blood gases, serum electrolytes, etc. If the product is ingested, unpredictable absorption may occur from the mouth and the gastrointestinal tract. Absorption of drugs from the gastrointestinal tract may be decreased by giving activated charcoal, which, in many cases, is more effective than emisis of lavage; consider charcoal instead of or in addition to gastric emptying. Repeated doses of charcoal over time may hasten elimination of some drugs that have been absorbed. Safeguard the patient's airway when employing gastric emptying or charcoal.Forced diuresis, peritoneal dialysis, hemodialysis, or charcoal hemoperfusion have not been established as beneficial for an overdose of dobutamine hydrochloride.

Store between 15-30° C.

Inotropic-sympathomimetics

Dobutamine increases contractility and heart rate by stimulating ?-adrenergic receptors in the cardiac tissues.

Pregnancy category: B Lactation: Unknown whether drug is excreted into breast milk; avoid use