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DOBUTAMINE
DESCRIPTION A synthetic catecholamine with primarily beta-1 adrenergic activity. An
inotropic vasopressor which increases myocardial contractility, cardiac
index, oxygen delivery and oxygen consumption. It decreases systemic and
pulmonary vascular resistance (adults). Dobutamine has a more prominent
effect on cardiac output than dopamine but less of an effect on blood
pressure. There is no evidence of a significant difference between
dopamine and dobutamine in terms of left ventricular output, tachycardia,
neonatal mortality, incidence of periventricular leukomalacia or severe
periventricular haemorrhage. Dopamine was more successful than
dobutamine in treating systemic hypotension, with fewer infants having
treatment failure.
PHARMACOKINETICS Onset of action is 2-4 minutes with peak effect in 10 minutes. Duration of
action is 7 minutes, necessitating a continuous IV infusion. Half-life is 2
minutes. Rapidly metabolised in the liver. Pharmacokinetic studies have
demonstrated wide variations in plasma concentrations between individuals
for a given dose of dobutamine. This is likely to be related to differences in
plasma clearance rates which are independent of birthweight and
gestational age. In addition, there is a poor correlation between plasma
dobutamine concentration and blood pressure response.
DOBUTAMINE SHOULD ALWAYS HAVE ITS OWN LINE AND NOT BE MIXED WITH ANYTHING
TO AVOID ACCIDENTAL BOLUS.
STORAGE Diluted solution is stable for 24 hours. Dobutamine solution may exhibit a
pink colour that, if present, will increase with time. This is due to slight
oxidation of the drug but does not lose its potency.
DOBUTAMINE cont
TERMINAL INJECTION SITE COMPATIBILITY dextrose, amino acid and fat emulsion, atropine,
amiodarone, calcium chloride and gluconate, dopamine, epinephrine, fluconazole, heparin,
hydrocortisone, lidocaine, magnesium sulphate, meropenem, midazolam, morphine, pancuronium,
penicillin G, potassium chloride, propofol, ranitidine, vecuronium.
REFERENCE
Young TE, Magnum B: Neofax: A Manual of drugs used in neonatal care, ed 14. Raleigh, North Carolina: Acorn Publishing,
USA, 2001, p.94-95.
Subhedar NV, Shaw NJ. Dopamine versus dibutamine for hypotensive preterm infants. Cochrane
Database Syst Rev 2000; CD001242.