Dobutamine
A synthetic catecholamine that mainly stimulates beta-1 receptors, infused for short-term support of a failing, poorly contracting heart.
Drug card
- Class
- Sympathomimetic
- How it works
- Activating beta-1 receptors, so the heart contracts more strongly
- Used for
- Short-term support of a heart with weak contraction
- Low cardiac output after heart surgery
- Known for
- Fast heart rate
- Ventricular ectopic beats and arrhythmias
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does dobutamine work?
A direct-acting synthetic catecholamine that works mainly on beta-1 receptors, raising the force of contraction and stroke volume with comparatively little rise in heart rate. Its weaker beta-2 and alpha-1 actions leave vascular resistance little changed or slightly lower. Unlike dopamine, it does not release norepinephrine from nerve endings.
Like other sympathomimetics: They activate adrenergic receptors, copying the norepinephrine and epinephrine of the sympathetic nervous system. Alpha-1 activation constricts blood vessels, beta-1 activation makes the heart beat faster and harder, and beta-2 activation relaxes bronchial and some vascular smooth muscle. Each drug's mix of receptors decides its use, and the catecholamines here are given by injection or infusion and act briefly.
Uses
What is dobutamine used for?
- Short-term support of a heart with weak contraction
- Low cardiac output after heart surgery
Side effects
Side effects of dobutamine
- Fast heart rateKnown for
- Ventricular ectopic beats and arrhythmiasKnown forSerious
- Rise in blood pressure
- Angina and chest painSerious
- Palpitations
- Shortness of breath
- Nausea
- Headache
- Low potassium
- Sudden fall in blood pressure (occasional)Serious
- Phlebitis or skin necrosis if the infusion leaks
- Allergic reactions: rash, fever, bronchospasm
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- Contraindicated in hypertrophic obstructive cardiomyopathy (idiopathic hypertrophic subaortic stenosis).
- Atrial fibrillation: it speeds AV conduction and the ventricular rate can race, so digoxin is given first.
- Some products contain sulfite, which can cause allergic reactions, more often in people with asthma.
- Pre-existing hypertension makes an exaggerated rise in blood pressure more likely.
Good to know: Raises cardiac output mainly through a bigger stroke volume rather than a faster rate, unlike isoproterenol.
Remember it
A way to remember it
Norepinephrine squeezes, dobutamine pumps, epinephrine does both and opens the airways.
Norepinephrine acts mostly on alpha-1 receptors and constricts vessels; dobutamine acts mostly on beta-1 receptors and strengthens the heartbeat; epinephrine acts on alpha and beta receptors, and its beta-2 action relaxes the airways, which is why it is used in anaphylaxis.
Written for biofideX
Its class
Sympathomimetics
Other sympathomimetics with a card:
Easily mixed up with beta blockers, alpha-1 blockers and short-acting beta-2 agonists.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Autonomic nervous system
Dobutamine is one of 10 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
Start Practicing