DOBUTAMINE

• Cardiogenic shock
• Septic shock
• Cardiomyopathies
• Cardiac surgery
• Cardiac stress testing (see product literature)

Given as a continuous IV infusion

• Dilute to 0.5–1 mg/ml (max 5 mg/ml in fluid restriction given with an infusion pump) with glucose 5% or sodium chloride 0.9% (normal saline). Incompatible with bicarbonate and strong alkaline solutions
• Higher concentrations given by central venous catheter
• For use in neonatal intensive care, dilute 30 mg/kg to a final volume of 50 ml (infused at 0.5 ml/hour gives 0.005 mg/kg/minute)

• Pheochromocytoma
• Previous hypersensitivity to dobutamine

• Eosinophilia, inhibition of thrombocyte aggregation when used over a number of days
• Headache, fever, exanthema
• Increase in heart rate and blood pressure, hypotension
• Arrhythmias, palpitations, vasoconstriction in previous treatment with beta receptor blockers, chest pain, angina pain, ventricular extra-systoles
• Bronchospasm
• Nausea
• Phlebitis at injection site

• Isoflurane(risk of ventricular arrhythmias)
• Monoamine oxidase inhibitors (MAOIs) such as selegiline (risk of hypertensive crisis)
• Non-cardioselective beta-blockers (increased risk of severe hypertension and bradycardia)

• Can be used

• Can be used

• Use with caution in arrhythmias, acute myocardial infarction, acute heart failure, severe hypotension, marked obstruction of cardiac ejection and hypothyroidism
• Correct hypovolemia before starting treatment
• There is a risk of tolerance when continuous infusions are given for longer than 72 hours