Dobutamina
Dobutamine
Dobutamine HCl
También conocido como: Dobutrex · Posiject · 46236 · compound 81929 · dobutamini hydrochloridum · LY-174008 · Dobutamina · Dobutaminum
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Evidencia posológica v13 auditada
Evidencia estructurada para el cálculoHypotension during general anesthesia (extra-label)
Requiere verificación veterinaria
NA
Contexto clínico obligatorio (2)
- NOTE: Dobutamine is administered as an IV CRI and should be used only in critical care settings where adequate monitoring (eg, continuous BP, ECG, cardiac output, pulmonary capillary wedge pressure) can be provided.
- Dobutamine injection should be stored at room temperature, 20°C to 25°C (68°F-77°F); diluted solutions should be used within 24 hours.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La dobutamina es una catecolamina sintética y un agente inotrópico positivo inyectable de acción rápida.
Las características clínicas clave incluyen:
- Uso principal: Manejo a corto plazo de la insuficiencia cardíaca aguda (p. ej., miocardiopatía dilatada) y shock cardiogénico.
- Soporte hemodinámico: Se utiliza cuando la fluidoterapia por sí sola no logra restaurar una presión arterial, un gasto cardíaco o una perfusión tisular aceptables.
- Perla clínica: Debido a su vida media extremadamente corta, debe administrarse mediante infusión a velocidad constante (CRI) en una unidad de cuidados intensivos (UCI) bajo estrecha monitorización. A diferencia de la dopamina, la dobutamina no depende de la liberación de norepinefrina endógena, lo que la hace más fiable en corazones con insuficiencia y agotamiento de catecolaminas.
Mecanismo de acción
Dobutamine acts primarily as a direct beta1-adrenergic agonist with mild beta2- and alpha1-adrenergic effects.
Mechanism Pathway: Dobutamine binds to beta-1 receptors on the myocardium → activates G-stimulatory (Gs) proteins → stimulates adenylyl cyclase → increases intracellular cyclic AMP (cAMP) → activates Protein Kinase A (PKA) → increases intracellular calcium influx → enhances myocardial contractility (positive inotropy).
Unlike dopamine, it does not cause the release of endogenous norepinephrine and lacks dopaminergic receptor activity. It increases cardiac output and stroke volume while decreasing left ventricular filling pressures (wedge pressures), with minimal direct effect on systemic vasculature. Higher doses can induce tachycardia.
Seguridad y advertencias
Contraindicaciones
- Known hypersensitivity to dobutamine or the preservative sodium bisulfite
- Idiopathic hypertrophic subaortic stenosis (IHSS)
- Uncorrected hypovolemic states
- Cardiac outflow obstruction (e.g., aortic stenosis)
Efectos adversos
- Tachycardia
- Facial twitching (especially in dogs)
- Tachyphylaxis (increasing dosages required over time)
- CNS effects such as tremors or seizures (especially in cats at >5 mcg/kg/min)
- Ectopic beats
- Increased blood pressure
- Chest pain and palpitations (reported in humans)
- Proarrhythmia (ventricular arrhythmias)
- Hypertension
- Hypokalaemia (with prolonged use)
- Nausea
- Vomiting
- Seizures (particularly in cats at higher doses)
Precauciones
Warning: Hypovolemic states must be corrected before administering dobutamine.
- Cardiac Arrhythmias: Use with extreme caution in patients with ventricular tachyarrhythmias or atrial fibrillation. Dobutamine can enhance atrioventricular conduction; animals with atrial fibrillation should be digitalized prior to receiving dobutamine.
- Myocardial Infarction: Use very cautiously post-MI as it may increase myocardial oxygen demand and infarct size.
- Equine Electrocardioversion: In horses receiving electrocardioversion for atrial fibrillation, stop dobutamine for at least 5 minutes before shock delivery.
Interacciones farmacológicas
May result in increased incidences of ventricular arrhythmias
May antagonize the cardiac effects of dobutamine, resulting in a preponderance of alpha-adrenergic effects and increased total peripheral resistance
Synergistic effects (increased cardiac output and reduced wedge pressure) can result
May induce severe hypertension when used with dobutamine in obstetric patients
Increased insulin requirements in diabetic patients
Increased systemic vascular resistance
Increased systemic vascular resistance
Increased systemic vascular resistance (MAOI interaction)
Increased incidence of arrhythmias
Recommended prior/concurrently in cases of atrial fibrillation to prevent increased ventricular rate
Monitorización
- Heart rate and rhythm (ECG)
- Mucous membrane color and capillary refill time
- Urine flow/output
- Central venous or pulmonary wedge pressures (ideally)
- Cardiac output
- Continuous ECG
- Arterial blood pressure (direct preferred)
- Serum potassium levels
Farmacocinética
Vida media
Absorción
Rapidly metabolized in the GI tract; not available orally. Administered only as a constant IV infusion. Onset of action generally occurs within 2 minutes and peaks after 10 minutes.
Distribución
It is unknown if dobutamine crosses the placenta or into milk.
Metabolismo
Metabolized rapidly in the liver and other tissues.
Eliminación
The drug's effects diminish rapidly after cessation of therapy.
Sobredosis
Clinical signs reported with excessive dosage include tachycardias, increased blood pressure, nervousness, and fatigue.
Because of the drug's extremely short duration of action, temporarily halting the intravenous infusion is usually all that is required to reverse these adverse effects.
Productos disponibles
Formulaciones
- Injection Concentrated Solution
- Solution for Injection
- Injectable: 12.5 mg/ml solution
- Injectable: 50 mg/ml solution
Veterinario
- Dobutamine 12.5 mg/ml injectable solution
- Dobutamine 50 mg/ml injectable solution
Etiquetado para humanos
- Dobutamine HCl Injection Concentrated Solution: 12.5 mg/mL in 20 mL & 40 mL single-use vials & 100 mL pharmacy bulk packages
- Dobutamine HCL Solution for Injection: 250 mg/250 mL (1 mg/mL), 500 mg/500 mL (1 mg/mL), 500 mg/250 mL (2 mg/mL), & 1,000 mg/250 mL (4 mg/mL) preservative free
- Dobutamine Hydrochloride in 5% Dextrose Injection
- Dobutamine 12.5 mg/ml injectable solution (Dobutrex)
Estado regulador
POM (Prescription Only Medicine)
POM-V
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Dobutamine injection should be stored at room temperature (15-30°C); diluted solutions should be used within 24 hours.
Información para el cliente
Nota: La dobutamina es estrictamente un medicamento de cuidados intensivos y no se prescribe para uso doméstico.
- Propósito: Este medicamento se administra mediante un goteo intravenoso (IV) continuo para ayudar a que el corazón de su mascota bombee con mayor eficacia durante una enfermedad crítica, shock o una crisis grave de insuficiencia cardíaca.
- Monitorización: Su mascota permanecerá en la UCI, donde el personal veterinario puede monitorizar continuamente su frecuencia cardíaca, ECG y presión arterial.
- Seguridad: Debido a que el fármaco actúa muy rápidamente y se elimina del organismo con rapidez, el equipo veterinario puede ajustar fácilmente la dosis minuto a minuto para garantizar la seguridad y el bienestar de su mascota.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.