ドブタミン
Dobutamine
Dobutamine HCl
別名: Dobutrex · Posiject · 46236 · compound 81929 · dobutamini hydrochloridum · LY-174008 · Dobutamina · Dobutaminum
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
監査済み v13 用量エビデンス
構造化された用量計算エビデンスHypotension during general anesthesia (extra-label)
認証済み獣医師の確認が必要
NA
必ず考慮する臨床コンテキスト (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.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
ドブタミンは合成カテコールアミンであり、速効性の注射用陽性変力薬（強心薬）です。
主な臨床的特徴：
- 主な用途： 急性心不全（拡張型心筋症など）および心原性ショックの短期治療。
- 血行動態サポート： 輸液療法単独では適切な動脈血圧、心拍出量、または組織灌流を回復できない場合に使用されます。
- 臨床上のポイント： 半減期が非常に短いため、厳密にモニタリングされた集中治療室（ICU）環境で持続静脈内輸液（CRI）として投与する必要があります。ドパミンとは異なり、内因性ノルエピネフリンの放出に依存しないため、カテコールアミンが枯渇した不全心においてより信頼性が高くなります。
作用機序
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.
安全性・警告
禁忌
- Known hypersensitivity to dobutamine or the preservative sodium bisulfite
- Idiopathic hypertrophic subaortic stenosis (IHSS)
- Uncorrected hypovolemic states
- Cardiac outflow obstruction (e.g., aortic stenosis)
有害事象
- 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)
注意事項
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.
医薬品相互作用
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
監視
- 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
薬物動態
半減期
吸収
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.
分布
It is unknown if dobutamine crosses the placenta or into milk.
代謝
Metabolized rapidly in the liver and other tissues.
消失
The drug's effects diminish rapidly after cessation of therapy.
過剰投与
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.
製品
製剤
- Injection Concentrated Solution
- Solution for Injection
- Injectable: 12.5 mg/ml solution
- Injectable: 50 mg/ml solution
動物用医薬品
- Dobutamine 12.5 mg/ml injectable solution
- Dobutamine 50 mg/ml injectable solution
ヒト用医薬品
- 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)
規制ステータス
POM (Prescription Only Medicine)
POM-V
規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Dobutamine injection should be stored at room temperature (15-30°C); diluted solutions should be used within 24 hours.
飼主向け情報
注意： ドブタミンは厳密には集中治療用の薬剤であり、家庭用として処方されることはありません。
- 目的： この薬は、重篤な病気、ショック、または重度の心不全の危機において、ペットの心臓がより効果的に血液を送り出すのを助けるために、持続静脈内（IV）点滴として投与されます。
- モニタリング： ペットはICU（集中治療室）に入院し、獣医療スタッフが心拍数、心電図、血圧を継続的に監視します。
- 安全性： この薬は非常に早く効き、体内から急速に排出されるため、獣医療チームはペットの安全と快適さを確保するために、分単位で用量を簡単に調整することができます。
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