dobutamine
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)       :0.12–0.28half-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 functionHDF/high flux   :Not dialysed. Dose as in normal renal functionCAV/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
See how to identify renal failure stages according to GFR calculation
See how to diagnose irreversible renal disease
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