Presentation on theme: "Drug profile DOBUTAMINE. injection 250 mg per 5 ml ampule Store away from light & moisture at 15-30C(59-86F) Brand Name Manufacture Dosage Form Strength."— Presentation transcript:
Mechanism Of Action It directly effects β -1 receptor & stimulates adenylyl cyclase produces cAMP activates kinase protein phosphorylate Ca channel influx of Ca +2 contractility of heart & stroke volume that cardiac output. It has mild effect on β-2 & α receptors so reduces vascular resistance.
Adverse Effects Tachycardia Marked increase in systolic BP Phlebitis Nausea Headache Rare: Thrombocytopenia Shortness of breath Arrhythmias Angina pain
Contraindication/ Precaution Pregnancy Category B Idiopathic hypertrophic sub aortic stenosis Hypersensitivity to dobutamine or bisulfites Pregnancy Category B Idiopathic hypertrophic sub aortic stenosis Hypersensitivity to dobutamine or bisulfites
DOSAGE AND ADMINISTRATION: SR.NOIndication Route of Administration Recommended Dosage Range Duration of therapy Infants/Neonates mg/Kg/day & Frequency ChildAdult 1. Cardiac inotropic agent Continuous iv infusion 2-15 mcg/kg/min 5ug/kg initially then 2-20 ug/kg/min afterwards 2.5-5ug upto 40mcg/kg/ min Shouldnot exceed from 48 hrs 2. Cardiac decompensation Continuous iv infusion 2-15 mcg/kg/min Shouldnot exceed from 48 hrs 3.Acute heart failure Continuous iv infusion 2-15 mcg/kg/min 2.5-10 ug/kg/min Shouldnot exceed from 48 hrs 4.Cardiac shock Continuous iv infusion 2-15 mcg/kg/min 5ug/kg/mi n for 8min then upto 20 ug/kg/min Shouldnot exceed from 48 hrs 5.
Guidelines FOR IV ROUTE: Storage time & temperature after reconstruction Store in air tight container at 15-30 o, use within 24 hrs
Tricyclic antidepressants Tricyclic antidepressants (TCAs) may markedly enhance the pressor response to parenteral direct-acting sympathomimetic agents The mechanism is TCA inhibition of norepinephrine reuptake in adrenergic neurons, resulting in increased stimulation of adrenergic receptors. Parenteral administration of direct-acting sympathomimetic agents should preferably be avoided during therapy with tricyclic antidepressants except in cases of emergency (e.g., treatment of anaphylaxis). If concomitant use is necessary, initial dose and rate of administration of the sympathomimetic should be reduced, and cardiovascular status including blood pressure should be monitored closely Mechanism Recommendation
Beta blockers Beta-blockers may antagonize the cardiostimulatory effects of pressor agents by blocking beta-1 adrenergic receptors in the heart. In addition, peripheral vascular resistance may increase due to unopposed alpha-adrenergic effects of pressor agents in the presence of beta-blockade No specific intervention is necessary, but pharmacist should be alert to the potential for diminished cardiac response when pressor agents are used in patients treated with beta-blockers, including ophthalmic formulations. Mechanism Recommendation
DRUG-LAB INTERACTION: produce a mild reduction in serum potassium concentration, rarely to hypokalemic levels.
Toxic Dose Sign & Symptoms Rare anorexiaanorexia,nausea, vomiting, tremor, anxiety, palpitations, headache, shortness of breath, and anginal and nonspecific chest pain. The positive inotropic and chronotropic effects of dobutamine on the myocardium may causehypertension, tachyarrhythmiasnauseatremoranxietypalpitationsheadachechest paininotropicmyocardiumhypertension toxicology
discontinuing administration, establishing an airway, ensuring oxygenation and ventilation. Resuscitative measures should be initiated promptly. Severe ventricular tachyarrhythmias may be successfully treated with propranolol or lidocaine. Hypertension usually responds to a reduction in dose or discontinuation of therapy. Protect the patient’s airway and support ventilation and perfusion. Management/Treatment