Drug profile of dobutamine

this was made by me , i had really worked hard in making it in april 2013.

1. DRUG PROFILE PRESENTED BY: SYEDA ZAHRA AZIZ DOBUTAMINE

2. DOBUTAMINE ( Myocardiac stimulant )

3. Introduction ; Name of drug; Dobutamine (generic name) Dobutrex (trade name) Class of drug; Sympathomimetic ( beta-1 agonist) Vasopressor

4. Structure of dobutamine; ( synthetic catecholamine)

5. Pharmaceutical form; sterile injection

6. Qualitative and quantitave composition;

7. Pharmacodynamic proprties MECHANISM OF ACTION; Directly stimulates beta adrenergic receptor. Stimulation of Adenyl cyclase activity. Doesn‘t cause release of nor epinephrine . Cardiac Stimulation .

8. Positive inotropic effect on myocardium. Increase in cardiac output . Decrease in peripheral resistence . Increased myocardial Oxygen consumption. Increase in urine flow. Doesn‘t affect Dopaminergic receptor.

9. Pharmacokinetic parameters; Absorption; Following IV administration Onset of action is 2 min Peak plasma conc. of drug is 10 min after initiation of an IV infusion. Distribution; Metabolism; ( in liver) Methylaion and Conjugation Elimination; Plasma half-life is 2 min Excretion mainly through urine.

10. Indications; Inotropic support Cardiac failure Open heart surgery Positve end expiratory pressure Alternative to exercise in Cardiac stress testing.

11. Cardiac stress testing; It is a test used in medicine and cardiology to measure Heart‘s ability to respond to the external stress in a controlled clinical environment.

12. Contraindications; Hypersensitivity to dobutamine. Pheochromocytoma Must not be used in myocardial ischemia, in case of ; Recent myocardial infarction, Unstable angina pectoris, Stenosis of main left coronary artery, Heart failure

13. ECHOCARDIOGRAPHY; In this technique, heart disease is detected by using sound waves and this will generate image of heart.

14. Overdosage; Symptoms; Anorexia Nausea, vomiting, tremor Headache, chest pain Excessive Hypertention Tachycardia

15. Managment of toxicity; The initial action to be taken; Discontinuing administration of drug. Ensuring oxygenation and ventilation. If product is ingested , then absorption of drug from GIT may be decreased by giving activated charcoal. It is better than emesis and gastric lavage.

16. Adverse Drug Reaction; Immune system disorders; Hypersensitivity reactions including; rash fever Anaphylactic reactions and severe life-threatening asthmatic episodes may be due to sulphite sensitivity.

17. Metabolism and nutrition disorder; Hypokalemia Central Nervous System; Headache Tremor Restlessness Feeling of anxiety

18. Cardiovascular system ; Increase in heart beat by >30 beats/min. Vasoconstriction Anginal pain Tachycardia Renal; Urinary urgency Respiratory; Shortness of breath GIT; nausea

19. Posology and route; Route; For IV use only Because of its shorter half life it is administered as continuous IV infusion. Dilutions Dosage of adult and the elderly; 2.5-10 mcg/kg/min 0.5mcg/kg/min Rarely upto 40mcg/kg/min may be required.

20. Rate of administration and duration of therapy should be adjusted according to patient response, as determined by measurement of; Heart rate Blood pressure Urine flow Children ; Safety and efficacy of dobutamine therapy in children have not been established.

21. Interactions; Halogenated anesthesia; Desflurane ; Onset : rapid Severity: major Documentation: possible Effect; death due to cardiac ischemia Mechanism; unknown Managment; this has not proven because of its severity,the possiblity of this drug be considered

22. H 2 - Anta gonist (cimitidine); Significance; 4 Onset; rapid Severity; moderate Documentation; possible Effects; increased hypertention Mechanism; unknown Managment; monitor blood pressure and adjust dobutamine dose.

23. Rauwolfia alkaloid ( Reserpine); Significance ; 2 Onset; rapid Severity; moderate Documentation; suspected Effect; it potentiate pressor response of dobutamine and results in incresed hypertention Mechanism; it depletes stores of catecholamines, increasing receptor sensitivity to dobutamine.

24. Pregnancy and lactation; Category; B Reproduction studies in rats and rabbits have revealed no evidence of impaired fertility, harm to the foetus , or teratogenic effects due to dobutamine . As there are no adequate and well-controlled studies in pregnant women, and as animal reproduction studies are not always predictive of human response, dobutamine should not be used during pregnancy unless the potential benefits out weigh the potential risks to the foetus .

25. Lab test interferences; None well documented

26. Precautions ; Use with extreme caution after myocardial ischemia Dose is decreased if there is undue increase in heart rate, systolic blood pressue or arrythmia is precipitated. Mild hypokalemia may occur. Sulphite sensitivity; Use with caution in sulphite – sensitive patients because it causes allergy.

27. Patient care consideration; Administration and storage; Administration only by IV infusion . Carton text shall contain the following statements :  “ Dilute to at least 50 ml volume before intravenous infusion ”   if not required immediately, the diluted solution may be stored for up to 24 hours in a refrigerator.”   Keep out of the reach of children   “ If only part used, discard the remaining solution”   “ Protect from light” “ Do not store above 25°C ”

28. Assessment and intervention; Obtain pt. History Monitor vital signs , ECG, cardiac output, urinary output etc Monitor potassium level Monitor placement of IV catheter to reduce risk of extravasation. If pt. has diabetes then monitor blood glucose level and then report to physician.

29. Patient and family education; Instruct patient to report these symptoms to physician and Pharmacist ; Pain or discomfort at IV site Any anginal pain

30. Councelling with patient ;

31. Patient should consult his physician and pharmacist for safe use of medication;

32. I believe that; PREVENTION IS BETTER THAN CURE

33. Keep ur mind, heart,body and soul healthy;

34. Make ur life style healthier;

35. Any Question ?

36. Thanks again all of you 