DOBUTAMINE Cardiac arrhythmia treatment.pptx

Dobutamin is a Cardiac Medicine which is important to treat cardiac arythmia

1. DOBUTAMINE

2. INTRODUCTION Dobutamin : Is a beta-1 agonist catecholamine that has cardiac stimulant action without evoking vasoconstriction or tachycardia. It is proposed as a cardiotonic after myocardial infarction or open heart surgery.

3. Pharmacologic Category Dobutamine is Adrenergic Agonist Agent; Inotrope it has Strong beta1 and weak beta2/alpha effects, resulting in increased cardiac output, blood pressure, and heart rate, as well as decreased peripheral vascular resistance

4. DOBUTAMINE: MECHANISM OF ACTION Dobutamine is a pharmacological agent with ionotropic and chronotropic effects depending on the dose. By binding and activating the β-1 receptors selectively, inotropic effects are achieved on the myocardium. The ionotropic effect of dobutamine enhances contractility, which in turn causes a decrease in end-systolic volume and an increase in stroke volume. The heart's cardiac output is increased by the increase in stroke volume.

5. INTERACTION Concomitant use of Dobutamine & Nitroprussside results in a higher cardiac out put and lower pulmonary aedge than when either of the drug is used alone

6. DOBUTAMINE: INDICATIONS For patients with Decompensated congestive heart failure Cardiac surgery Septicemia Myocardial stress testing

7. CONTRAINDICATIONS Dobutamine is contraindicated for : Patients with ideopatic subaortic stenosis and P atients who have previous manifestation of hypersensitivity to dobutamine .

8. Dobutamine: available dose The medication is available as dobutamine hydrochloride 1 mg/mL, 2 mg/mL, and 4 mg/mL in 250 ml and 250 mg/20 mL IV solution .

9. Dobutamine : Dose & Administration Adult dose for patients with Cardiac Decompensation 0.5-1 mcg/kg/min IV continuous infusion initially, then 2-20 mcg/kg/min; not to exceed 20 mcg/kg/min for patients with Low Cardiac Output (Off-label) as inotropic support 2-20 mcg/kg/min IV or IO; titrate to desired effect; not to exceed 20 mcg/kg/min

10. Pediatric dose For patients with Decompensat ed heart failure. 0.5-1 mcg/kg/min IV continuous infusion initially, then 2-20 mcg/kg/min; not to exceed 20 mcg/kg/min

11. DOBUTAMINE: ADVERSE EFFECT Chest pain Tachycardia Angina Ectopic beats Palpitations Hypertension Nausia Vomiting Tingling sensation Paraesthesia Dyspnea Headache Hypersensitivity ( rash, broncospasm and fever) Hypokalemia

12. NURSING INTERVENTION To optimize hemodynamics, correct hypovolemia if needed . administer the drug throgh large vein. During administration of dobutamine , monitor Blood pressure continuously; Pulmonary wedge pressure and Cardiac output should be monitored whenever possible to aid safe and effective infusion of dobutamine in 5% dextrose injection.

13. References https://www.uptodate.com/contents/dobutamine-drug-information?sectionName=Adult&topicId=9380&search=dobutamine&usage_type=panel&anchor=F161962&source=panel_search_result&selectedTitle=1%7E148&showDrugLabel=true&kp_tab=drug_general&display_rank=1#F161962 Alhayek S, Preuss CV. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Aug 14, 2023. Beta 1 Receptors. Kislitsina ON, Rich JD, Wilcox JE, Pham DT, Churyla A, Vorovich EB, Ghafourian K, Yancy CW. Shock - Classification and Pathophysiological Principles of Therapeutics. Curr Cardiol Rev. 2019;15(2):102-113. https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/021201s040lbl.pdf https://reference.medscape.com/drug/dobutamine-342434#10