DOBUTamine

DOBUTamine

Indication

  • An inotropic agent used to increase cardiac output
  • Stimulates myocardial beta1-adrenergic receptors, increasing contractility and heart rate

Dosage Guidelines

  • 5-20 microgram/kg/minute IV continuous infusion
  • Begin at low dose and titrate to effect every 15 to 30 minutes as per MD/NP order

Administration

  • IV continuous infusion
  • For patients 1 kg or less:
    • Use DOBUTamine 1 mg/mL
    • To make 50 mL of DOBUTamine [1 mg/mL] [50 mg/50 mL]:
    • Add 4 mL (50 mg) of DOBUTamine [12.5 mg/mL] to 46 mL of solution
  • For patients over 1 kg:
    • Use DOBUTamine 2 mg/mL
    • To make 50 mL of DOBUTamine [2 mg/mL] [100 mg/50 mL]:
    • Add 8 mL (100 mg) of DOBUTamine [12.5 mg/mL] to 42 mL of solution
  • Administer via central line whenever possible

Adverse Effects

  • Generally, dose-related: arrhythmias, increased heart rate and blood pressure
  • Phlebitis

Comments

  • Monitor blood pressure and ECG, urine output, heart rate and O2 saturation
  • Hypovolemia should be corrected prior to use
  • Check IV site routinely for extravasation
  • If extravasation occurs, consider the use of phentolamine 
  • Non-response/poor response in blood pressure after DOBUTamine use can be related to its peripheral vasodilatory properties

Supplied As

  • 12.5 mg/mL, 20 mL vial
  • Supplied by Pharmacy as standard concentrations: of 1 mg/mL (supplied as 50 mg/50 mL of IV fluid ordered) and 2 mg/mL (100 mg/50 mL of IV fluid ordered)
    • 1 kg or less: 1 mg/mL, supplied as 50 mg in 50 mL IV solution
    • Over 1 kg:  2 mg/mL, supplied as 100 mg in 50 mL IV solution
  • At LHSC, standard concentration reference charts are available on the NICU Intranet site

References

Lexi Sick Kids and Lexi Pediatric and Neonatal