dobutamine

CLINICAL USE

Inotropic agent

DOSE IN NORMAL RENAL FUNCTION

2.5–10 micrograms/kg/minute, increasing up to 40 micrograms/kg/minute according to response

PHARMACOKINETICS

Molecular weight :301.4; 337.8 (as hydrochloride)

%Protein binding :No data

%Excreted unchanged in urine :

<10 :

Volume of distribution (L/kg) :0.12–0.28

half-life – normal/ESRD (hrs) :2–4 minutes/–

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Dose as in normal renal function

HD :Not dialysed. Dose as in normal renal function

HDF/high flux :Not dialysed. Dose as in normal renal function

CAV/VVHD :Not dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsBeta-blockers: possibly severe hypotension with beta-blockersDopaminergics: effects possibly enhanced by entacapone; avoid concomitant use with rasagiline

ADMINISTRATION

Reconstition

–

Route

Continuous

IV infusion

centrally via CRIP (or peripherally via a large vein)

Rate of Administration

Varies with dose

Comments

Dilute to at least 50 mL with sodium chloride 0.9% or glucose 5% (less than 5 mg/mL, ideally 0.5–1 mg/mL)250 mg may be diluted in as little as 50 mL diluentMinimum volume 10 mg/mL or even undiluted; give strong solution via central line (UK Critical Care Group, Minimum Infusion Volumes for fluid restricted critically ill patients, 3rd Edition, 2006)

OTHER INFORMATION

Cardiac and BP monitoring advised Sodium bicarbonate rapidly inactivates dobutamineSolution may turn pink, but potency is unaffectedCan cause hypokalaemia

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