Positive inotropic effects are mediated by beta-1 adrenergic receptors in the heart; increases the force of mycocardial contraction with relatively minor effects on heart rate, arrhythmogenesis; has minor effects on blood vessels.

Indications

For inotropic support in the short-term treatment of adults with cardiac decompensation due to depressed contractility, resulting from either organic heart disease or from cardiac surgical procedures Investigational use in children with congenital heart disease undergoing diagnostic cardiac catheterization, to augment cardiovascular function

Contraindications/cautions

Contraindicated in the presence of IHSS; hypovolemia (dobutamine is not a substitute for blood, plasma, fluids, electrolytes, which should be restored promptly when loss has occurred and in any case before treatment with dobutamine); acute myocardial infarction (may increase the size of an infarct by intensifying ischemia); general anesthesia with halogenated hydrocarbons or cyclopropane, which sensitize the myocardium to catecholamines.

Use caution in the presence of diabetes, lactation.

Adverse effects

CNS: Headache
GI: Nausea
CV: Increase in heart rate, increase in systolic blood pressure, increase in ventricular ectopic beats (PVCs), anginal pain, palpitations, shortness of breath