Dobutamine - Revision history

Chris.Rishel at 01:19, 11 January 2024

2024-01-11T01:19:58Z

← Older revision		Revision as of 18:19, 10 January 2024
Line 79:		Line 79:

	[[Category:Drug reference]]		[[Category:Drug reference]]
			[[Category:Positive chronotropes]]
	<references />		<references />

Chris.Rishel: Formatting

2024-01-11T01:14:59Z

Formatting

← Older revision		Revision as of 18:14, 10 January 2024
Line 17:		Line 17:
	}}		}}

	Dobutamine is a direct-acting sympathomimetic with preferential activation of beta-1 adrenergic receptors accounting for most of its ionotropic and chronotropic effects. It is also active at beta-2 and alpha-1 adrenergic receptors. Its primary indication is the treatment of low cardiac output secondary to CHF, cardiogenic shock, septic shock, or following cardiac surgery; Dobutamine is also the preferred agent for pharmacologic cardiac stress testing in patients who cannot tolerate an exercise stress test.		'''Dobutamine''' is a direct-acting sympathomimetic with preferential activation of beta-1 adrenergic receptors accounting for most of its ionotropic and chronotropic effects. It is also active at beta-2 and alpha-1 adrenergic receptors. Its primary indication is the treatment of low cardiac output secondary to CHF, cardiogenic shock, septic shock, or following cardiac surgery; Dobutamine is also the preferred agent for pharmacologic cardiac stress testing in patients who cannot tolerate an exercise stress test.

	==Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. -->==		==Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. -->==
Line 50:		Line 50:

	====Mechanism of action<!-- Describe the mechanism of action for the primary uses of the drug. -->====		====Mechanism of action<!-- Describe the mechanism of action for the primary uses of the drug. -->====
	Dobutamine is a direct-acting synthetic catecholamine. It is formulated as a racemic mixture of 2 enantiomers, the positive enantiomer is predominantly a beta-agonist (beta-1 greater than beta-2), while the negative enantiomer has partial alpha-1 agonist effects. Dobutamine binding to beta-1 adrenergic receptors enhances voltage-gated calcium channel expression on cardiac myocytes and increases myocardial contractility, leading to larger stroke volumes and increased cardiac output. This increased cardiac output activates baroreceptors, which decrease systemic vascular resistance, resulting in minimal change to arterial blood pressure. ~~Dobutatmine~~ also has minor beta-2 and alpha-1 adrenergic stimulatory effects. <ref>{{Cite journal\|last=Ruffolo\|first=Robert R.\|date=1987-10\|title=Review: The Pharmacology of Dobutamine\|url=http://dx.doi.org/10.1097/00000441-198710000-00005\|journal=The American Journal of the Medical Sciences\|volume=294\|issue=4\|pages=244–248\|doi=10.1097/00000441-198710000-00005\|issn=0002-9629}}</ref>		Dobutamine is a direct-acting synthetic catecholamine. It is formulated as a racemic mixture of 2 enantiomers, the positive enantiomer is predominantly a beta-agonist (beta-1 greater than beta-2), while the negative enantiomer has partial alpha-1 agonist effects. Dobutamine binding to beta-1 adrenergic receptors enhances voltage-gated calcium channel expression on cardiac myocytes and increases myocardial contractility, leading to larger stroke volumes and increased cardiac output. This increased cardiac output activates baroreceptors, which decrease systemic vascular resistance, resulting in minimal change to arterial blood pressure. Dobutamine also has minor beta-2 and alpha-1 adrenergic stimulatory effects. <ref>{{Cite journal\|last=Ruffolo\|first=Robert R.\|date=1987-10\|title=Review: The Pharmacology of Dobutamine\|url=http://dx.doi.org/10.1097/00000441-198710000-00005\|journal=The American Journal of the Medical Sciences\|volume=294\|issue=4\|pages=244–248\|doi=10.1097/00000441-198710000-00005\|issn=0002-9629}}</ref>

	====Adverse effects<!-- Describe any potential adverse effects of the drug. -->====		====Adverse effects<!-- Describe any potential adverse effects of the drug. -->====
Line 74:		Line 74:

	==History<!-- Describe the historical development of the drug. -->==		==History<!-- Describe the historical development of the drug. -->==
	Dobutamine was developed by Drs. Tuttle and Mills in 1975, after they modified the structure of ~~isoproterenol~~. <ref>{{Cite journal\|last=Tuttle\|first=R R\|last2=Mills\|first2=J\|date=1975-01\|title=Dobutamine: development of a new catecholamine to selectively increase cardiac contractility.\|url=http://dx.doi.org/10.1161/01.res.36.1.185\|journal=Circulation Research\|volume=36\|issue=1\|pages=185–196\|doi=10.1161/01.res.36.1.185\|issn=0009-7330}}</ref>		Dobutamine was developed by Drs. Tuttle and Mills in 1975, after they modified the structure of [[isoprenaline]]. <ref>{{Cite journal\|last=Tuttle\|first=R R\|last2=Mills\|first2=J\|date=1975-01\|title=Dobutamine: development of a new catecholamine to selectively increase cardiac contractility.\|url=http://dx.doi.org/10.1161/01.res.36.1.185\|journal=Circulation Research\|volume=36\|issue=1\|pages=185–196\|doi=10.1161/01.res.36.1.185\|issn=0009-7330}}</ref>

	==References==		==References==

Mccarta: Wrote general description, uses, contraindications, pharmacology, history sections

2024-01-08T23:22:20Z

Wrote general description, uses, contraindications, pharmacology, history sections

← Older revision		Revision as of 16:22, 8 January 2024
Line 1:		Line 1:
	{{Infobox drug reference		{{Infobox drug reference
	\| trade_names =		\| trade_names =
	\| drug_class =		\| drug_class = Synthetic catecholamine
	\| drug_class_color = cardiovascular_agonist		\| drug_class_color = cardiovascular_agonist
	\| uses =		\| uses = Low cardiac output, pharmacologic cardiac stress echocardiography
	\| contraindications =		\| contraindications = Corn hypersensitivity, idiopathic hypertrophic subaortic stenosis
	\| routes = ~~Intravenous~~		\| routes = IV
	\| dosage =		\| dosage =
	\| dosage_calculation = dobutamine		\| dosage_calculation = dobutamine
			\| mechanism = beta-1 agonism (primary), beta-2 agonism and alpha-1 agonism (secondary)
			\| adverse_effects = Hypertension, hypotension, arrhythmia, hypokalemia, nausea, headache, chest pain
			\| time_onset = 1-2 minutes
			\| metabolism = Liver metabolism by catechol-O-methyltransferase and glucuronidation to inactive metabolites
			\| clearance = 90 mL/kg/min
			\| formula = C<sub>18</sub>H<sub>23</sub>NO<sub>3</sub>
			\| molar_mass = 301.38
	}}		}}

	~~Provide~~ a ~~brief summary~~ of ~~this drug here~~.		Dobutamine is a direct-acting sympathomimetic with preferential activation of beta-1 adrenergic receptors accounting for most of its ionotropic and chronotropic effects. It is also active at beta-2 and alpha-1 adrenergic receptors. Its primary indication is the treatment of low cardiac output secondary to CHF, cardiogenic shock, septic shock, or following cardiac surgery; Dobutamine is also the preferred agent for pharmacologic cardiac stress testing in patients who cannot tolerate an exercise stress test.

	== Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. --> ==		==Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. -->==

	== ~~Contraindications<!~~-- ~~List contraindications and precautions for use of the drug. -~~-> ==		*Low cardiac output secondary to congestive heart failure, cardiogenic shock, septic shock, or following cardiac surgery<ref name=":0">{{Citation\|title=Dobutamine in Dextrose Injection\|url=http://dx.doi.org/10.31003/uspnf_m27790_06_01\|publisher=U.S. Pharmacopeial Convention\|access-date=2024-01-08}}</ref>

	=== ~~Absolute contraindications<!~~-- ~~List absolute contraindications~~ for ~~use~~ of the ~~drug~~. ~~If none, this section may be removed~~. ~~-->~~ ===		*Stress echocardiography, preferred alternative test for evaluation of myocardial ischemia if the patient is unable to exercise, though this use is off-label<ref>{{Cite journal\|last=Pellikka\|first=Patricia A.\|last2=Arruda-Olson\|first2=Adelaide\|last3=Chaudhry\|first3=Farooq A.\|last4=Chen\|first4=Ming Hui\|last5=Marshall\|first5=Jane E.\|last6=Porter\|first6=Thomas R.\|last7=Sawada\|first7=Stephen G.\|date=2020-01\|title=Guidelines for Performance, Interpretation, and Application of Stress Echocardiography in Ischemic Heart Disease: From the American Society of Echocardiography\|url=http://dx.doi.org/10.1016/j.echo.2019.07.001\|journal=Journal of the American Society of Echocardiography\|volume=33\|issue=1\|pages=1–41.e8\|doi=10.1016/j.echo.2019.07.001\|issn=0894-7317}}</ref>

	==~~= Precautions~~<!-- List precautions for use of the drug~~. If none, this section may be removed~~. --> ===		==Contraindications<!-- List contraindications and precautions for use of the drug. -->==

	== ~~Pharmacology~~ ==		===Absolute contraindications<!-- List absolute contraindications for use of the drug. If none, this section may be removed. -->===

	~~=== Pharmacodynamics<!-- Describe the effects of the drug on the body. If appropriate~~, ~~add subsections by organ system --> ===~~		*Corn hypersensitivity, as premixed bags contain dextrose

	~~==== Mechanism of action<!-- Describe the mechanism of action for the primary uses of the drug. --> ====~~		*Idiopathic hypertrophic subaortic stenosis

	===~~= Adverse effects~~<!-- ~~Describe any potential adverse effects~~ of the drug. --> ====		===Precautions<!-- List precautions for use of the drug. If none, this section may be removed. -->===

	=== ~~Pharmacokinetics~~<!-- ~~Describe the pharmacokinetics of the drug~~. --> ===		*Acute myocardial infarction and coronary artery disease, as dobutamine may worsen myocardial ischemia
			*Atrial fibrillation, ventricular arrhythmias, as dobutamine increases AV conduction and can precipitate or worsen ectopic activity<ref>{{Cite journal\|last=David\|first=Shukri\|last2=Zaks\|first2=Jeffrey M.\|date=1986-02\|title=Arrhythmias Associated with Intermittent Outpatient Dobutamine Infusion\|url=http://dx.doi.org/10.1177/000331978603700203\|journal=Angiology\|volume=37\|issue=2\|pages=86–91\|doi=10.1177/000331978603700203\|issn=0003-3197}}</ref>
			*Hypertension
			*Hypotension and hypovolemia
			*Renal failure, as continuous infusions may result in myoclonia<ref>{{Cite journal\|last=Wierre\|first=L.\|last2=Decaudin\|first2=B.\|last3=Barsumau\|first3=J.\|last4=Vairon\|first4=M. X.\|last5=Horrent\|first5=S.\|last6=Odou\|first6=P.\|last7=Azar\|first7=R.\|date=2004-04-21\|title=Dobutamine-induced myoclonia in severe renal failure\|url=http://dx.doi.org/10.1093/ndt/gfh132\|journal=Nephrology Dialysis Transplantation\|volume=19\|issue=5\|pages=1336–1337\|doi=10.1093/ndt/gfh132\|issn=0931-0509}}</ref>
			*Premature neonates, as dobutamine has been shown to be less effective than dopamine in this population<ref name=":0" />
			*Geriatric patients
			*Pregnancy and breast feeding<ref name=":0" />
			*Sulfite hypersensitivity, as some preparations include sulfites<ref name=":0" />

	== ~~Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. -->~~ ==		==Pharmacology==

	== ~~History~~<!-- Describe the ~~historical development~~ of the drug. --> ==		===Pharmacodynamics<!-- Describe the effects of the drug on the body. If appropriate, add subsections by organ system -->===

	== References ==		====Mechanism of action<!-- Describe the mechanism of action for the primary uses of the drug. -->====
			Dobutamine is a direct-acting synthetic catecholamine. It is formulated as a racemic mixture of 2 enantiomers, the positive enantiomer is predominantly a beta-agonist (beta-1 greater than beta-2), while the negative enantiomer has partial alpha-1 agonist effects. Dobutamine binding to beta-1 adrenergic receptors enhances voltage-gated calcium channel expression on cardiac myocytes and increases myocardial contractility, leading to larger stroke volumes and increased cardiac output. This increased cardiac output activates baroreceptors, which decrease systemic vascular resistance, resulting in minimal change to arterial blood pressure. Dobutatmine also has minor beta-2 and alpha-1 adrenergic stimulatory effects. <ref>{{Cite journal\|last=Ruffolo\|first=Robert R.\|date=1987-10\|title=Review: The Pharmacology of Dobutamine\|url=http://dx.doi.org/10.1097/00000441-198710000-00005\|journal=The American Journal of the Medical Sciences\|volume=294\|issue=4\|pages=244–248\|doi=10.1097/00000441-198710000-00005\|issn=0002-9629}}</ref>

			====Adverse effects<!-- Describe any potential adverse effects of the drug. -->====

			*Hypertension
			*Hypotension due to decreased systemic vascular resistance
			*Tachycardia
			*Rapid ventricular response or premature ventricular contractions
			*Hypokalemia
			*Nausea
			*Headaches
			*Chest pain
			*Palpitations
			*Shortness of breath

			===Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. -->===

			*Onset of action: 1-2 minutes, though peak effect can take up to 10 minutes
			*Plasma half-life: 2 minutes
			*Metabolized in the liver catechol-O-methyltransferase and by glucuronidation to inactive metabolites, excretion of metabolites via the kidneys

			==Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. -->==

			==History<!-- Describe the historical development of the drug. -->==
			Dobutamine was developed by Drs. Tuttle and Mills in 1975, after they modified the structure of isoproterenol. <ref>{{Cite journal\|last=Tuttle\|first=R R\|last2=Mills\|first2=J\|date=1975-01\|title=Dobutamine: development of a new catecholamine to selectively increase cardiac contractility.\|url=http://dx.doi.org/10.1161/01.res.36.1.185\|journal=Circulation Research\|volume=36\|issue=1\|pages=185–196\|doi=10.1161/01.res.36.1.185\|issn=0009-7330}}</ref>

			==References==

	[[Category:Drug reference]]		[[Category:Drug reference]]
			<references />

Chris.Rishel at 07:59, 30 March 2022

2022-03-30T07:59:28Z

← Older revision		Revision as of 00:59, 30 March 2022
Line 5:		Line 5:
	\| uses =		\| uses =
	\| contraindications =		\| contraindications =
	\| routes = IV		\| routes = Intravenous
	\| dosage =		\| dosage =
	\| dosage_calculation = dobutamine		\| dosage_calculation = dobutamine

Chris.Rishel: Added embedded dosage calculation

2022-03-30T07:49:19Z

Added embedded dosage calculation

← Older revision		Revision as of 00:49, 30 March 2022
Line 2:		Line 2:
	\| trade_names =		\| trade_names =
	\| drug_class =		\| drug_class =
	\| drug_class_color =		\| drug_class_color = cardiovascular_agonist
	\| uses =		\| uses =
	\| contraindications =		\| contraindications =
	\| routes =		\| routes = IV
	\| dosage =		\| dosage =
			\| dosage_calculation = dobutamine
	}}		}}

Oliviamsutton: Created page with "{{Infobox drug reference | trade_names = | drug_class = | drug_class_color = | uses = | contraindications = | routes = | dosage = }} Provide a brief summary of this dr..."

2021-11-10T17:25:41Z

Created page with "{{Infobox drug reference | trade_names = | drug_class = | drug_class_color = | uses = | contraindications = | routes = | dosage = }} Provide a brief summary of this dr..."

New page

{{Infobox drug reference
| trade_names =
| drug_class =
| drug_class_color =
| uses =
| contraindications =
| routes =
| dosage =
}}

Provide a brief summary of this drug here.

== Uses ==

== Contraindications ==

=== Absolute contraindications ===

=== Precautions ===

== Pharmacology ==

=== Pharmacodynamics ===

==== Mechanism of action ====

==== Adverse effects ====

=== Pharmacokinetics ===

== Chemistry and formulation ==

== History ==

== References ==

[[Category:Drug reference]]