Dobutamine

Source: Wikipedia, the free encyclopedia.
Dobutamine
Clinical data
Trade namesDobutrex, Inotrex, others
AHFS/Drugs.comMonograph
MedlinePlusa682861
License data
Pregnancy
category
β1-agonist
ATC code
Legal status
Legal status
  • In general: ℞ (Prescription only)
Pharmacokinetic data
Onset of actionWithin 2 min[2]
Elimination half-life2 minutes
Identifiers
  • (RS)-4-(2-{[4-(4-hydroxyphenyl)butan-2-yl]amino}ethyl)benzene-1,2-diol
JSmol)
ChiralityRacemic mixture
  • Oc1ccc(cc1O)CCNC(C)CCc2ccc(O)cc2
  • InChI=1S/C18H23NO3/c1-13(2-3-14-4-7-16(20)8-5-14)19-11-10-15-6-9-17(21)18(22)12-15/h4-9,12-13,19-22H,2-3,10-11H2,1H3 checkY
  • Key:JRWZLRBJNMZMFE-UHFFFAOYSA-N checkY
  (verify)

Dobutamine is a medication used in the treatment of

continuous infusion.[2] The amount of medication needs to be adjusted to the desired effect.[2] Onset of effects is generally seen within 2 minutes.[2] It has a half-life of two minutes. This drug is generally only administered short term, although it may be used for longer periods to relieve symptoms of heart failure in patients awaiting heart transplantation.[4]

Common side effects include a

β1 receptors, which increases the strength of the heart's contractions, leading to a positive inotropic effect. Generally it has little effect on a person's heart rate.[2]

Dobutamine was approved for medical use in the United States in 1978.

isoproterenol.[3]

Medical uses

Dobutamine is used to treat acute but potentially reversible heart failure, such as which occurs during cardiac surgery or in cases of septic or cardiogenic shock, on the basis of its positive inotropic action.[6]

Dobutamine can be used in cases of

ischemic heart disease because it increases heart rate and thus increases myocardial oxygen demand.[7]

The drug is also commonly used in the hospital setting as a pharmacologic stress testing agent to identify coronary artery disease.

Adverse effects

Primary side effects include those commonly seen for β1 active sympathomimetics, such as

arrhythmia, and tachycardia. Used with caution in atrial fibrillation as it has the effect of increasing the atrioventricular (AV) conduction.[8]

The most dangerous side effect of dobutamine is increased risk of arrhythmia, including fatal arrhythmias.

Overall, dobutamine tends to produce less tachycardia and peripheral vascular effects than agents such as epinephrine and isoproterenol.

Pharmacology

Dobutamine is a direct-acting agent whose primary activity results from stimulation of the

β1-adrenoceptors of the heart, increasing contractility and cardiac output. Since it does not act on dopamine receptors to inhibit the release of norepinephrine (another α1 agonist), dobutamine is less prone to induce hypertension than is dopamine
.

Dobutamine is predominantly a

inotropic effect in increasing heart contractility and cardiac output. Dobutamine is administered as a racemic mixture consisting of both (+) and (−) isomers; the (+) isomer is a potent β1 agonist and α1 antagonist, while the (−) isomer is an α1 agonist.[9] The administration of the racemate results in the overall β1 agonism responsible for its activity. (+)-Dobutamine also has mild β2 agonist activity, which makes it useful as a vasodilator.[10]

History

It was developed in the 1970s by Drs. Ronald Tuttle and Jack Mills at

structural analogue of isoprenaline.[11]

References

  1. ^ a b "Dobutamine (Dobutrex) Use During Pregnancy". Drugs.com. 18 March 2020. Retrieved 17 May 2020.
  2. ^ a b c d e f g h i j k "Dobutamine Hydrochloride Monograph for Professionals". Drugs.com. AHFS. Retrieved 11 January 2019.
  3. ^
    ISBN 978-1-4200-1684-0
    .
  4. PMID 34191408
    .
  5. ^
    ISBN 978-0-85711-338-2
    .
  6. ^ Rang HP, Dale MM, Ritter JM, Flower RJ. Rang and Dale's Pharmacology.
  7. PMID 26690127
    .
  8. ISBN 978-1-59541-101-3
    .
  9. ISBN 978-0-07-144343-2
    .
  10. PMID 9279221
    .
  11. PMID 234805
    .

External links

  • "Dobutamine". Drug Information Portal. U.S. National Library of Medicine.
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