Dobutamine is a sympathomimetic drug used in the treatment of heart failure and cardiogenic shock. The main mechanism is direct stimulation of the 1 receptor of the sympathetic nervous system. Dobutamine was developed in 1970 by Drs. Ronald Tuttle and Jack Mills at Eli Lilly and Company, as an isoprenalal structural analogue.
Video Dobutamine
Clinical use
Dobutamine is used to treat acute but potentially reversible heart failure, as occurs during cardiac surgery or in cases of septic or cardiogenic shock, on the basis of positive inotropic action.
Dobutamine can be used in cases of congestive heart failure to increase cardiac output. This is indicated when parenteral therapy is required for inotropic support in short-term treatment of patients with cardiac decompensation due to contractility of depression, which can be the result of organic heart disease or heart surgery procedures. It is useless in ischemic heart disease because it increases heart rate and thus increases myocardial oxygen demand.
It is also commonly used in hospitals as pharmacological stress testing agents to identify coronary artery disease.
Maps Dobutamine
Adverse effects
Primary side effects include those commonly seen for? 1 active sympathomimetics, such as hypertension, angina, arrhythmias, and tachycardia. It is used with caution in atrial fibrillation because it has the effect of increasing atrioventricular (AV) conduction.
The most dangerous side effect of dobutamine is an increased risk of arrhythmias, including fatal arrhythmias.
Pharmacology
Dobutamine is a direct-acting agent whose primary activity results from the stimulation of <1> -adrenoceptors of the heart, increases contractility and cardiac output. Because it does not act on dopamine receptors to induce norepinephrine release (another? 1 agonist), dobutamine is less prone to induce hypertension than dopamine.
Dobutamine is dominated by? 1 -adrenergic agonist, with weak activity? 2 , and? 1 selective, although it is used clinically in cases of cardiogenic shock due to its inotropic effect 1 in improving cardiac contractility and cardiac output. Dobutamine is given as a racemic mixture comprising isomers () and (-); isomer () is a powerful agonist? 1 and? 1 , while the (-) isomer is an agonist? 1 . The racemic administration produces an overall agonist <1> responsible for its activities. () - Dobutamine also has mild agonist activity? 2 , which makes it useful as a vasodilator.
See also
- Adenosine
- Arbutamine
- Ractopamine (dobutamine regioisomer)
References
Source of the article : Wikipedia
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