도부타민
Dobutamine
Dobutamine HCl
다른 이름: Dobutrex · Posiject · 46236 · compound 81929 · dobutamini hydrochloridum · LY-174008 · Dobutamina · Dobutaminum
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
감사 완료 v13 용량 근거
구조화 용량 계산 근거Hypotension during general anesthesia (extra-label)
인증된 수의사 확인 필요
NA
반드시 함께 고려할 임상 맥락 (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.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
도부타민(Dobutamine)은 합성 카테콜아민이며 속효성 주사용 양성 변력성 약물(강심제)입니다.
주요 임상적 특징은 다음과 같습니다:
- 주요 용도: 급성 심부전(예: 확장성 심근병증) 및 심인성 쇼크의 단기 치료.
- 혈역학적 지원: 수액 요법만으로 적절한 동맥 혈압, 심박출량 또는 조직 관류를 회복하지 못할 때 사용됩니다.
- 임상 요점: 반감기가 매우 짧기 때문에 면밀히 모니터링되는 중환자실(ICU) 환경에서 지속적 정맥 주입(CRI)으로 투여해야 합니다. 도파민과 달리 내인성 노르에피네프린의 방출에 의존하지 않으므로 카테콜아민이 고갈된 심부전 환자에게 더 신뢰할 수 있습니다.
작용 기전
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.
안전성·주의사항
금기사항
- Known hypersensitivity to dobutamine or the preservative sodium bisulfite
- Idiopathic hypertrophic subaortic stenosis (IHSS)
- Uncorrected hypovolemic states
- Cardiac outflow obstruction (e.g., aortic stenosis)
부작용
- 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)
주의
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.
약물 상호작용
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
모니터링
- 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
약동학
반감기
흡수
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.
분포
It is unknown if dobutamine crosses the placenta or into milk.
대사
Metabolized rapidly in the liver and other tissues.
배설
The drug's effects diminish rapidly after cessation of therapy.
과다투여
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.
제품
제형
- Injection Concentrated Solution
- Solution for Injection
- Injectable: 12.5 mg/ml solution
- Injectable: 50 mg/ml solution
동물용의약품
- Dobutamine 12.5 mg/ml injectable solution
- Dobutamine 50 mg/ml injectable solution
인용의약품
- 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)
규제 현황
POM (Prescription Only Medicine)
POM-V
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Dobutamine injection should be stored at room temperature (15-30°C); diluted solutions should be used within 24 hours.
보호자 정보
참고: 도부타민은 엄격한 중환자실 전용 약물이며 가정용으로 처방되지 않습니다.
- 목적: 이 약물은 위기 상황, 쇼크 또는 심각한 심부전 발생 시 반려동물의 심장이 더 효과적으로 혈액을 펌프질할 수 있도록 지속적인 정맥(IV) 점적 주사로 투여됩니다.
- 모니터링: 반려동물은 중환자실(ICU)에 머물게 되며, 수의 전문 의료진이 심박수, 심전도 및 혈압을 지속적으로 모니터링합니다.
- 안전성: 약물이 매우 빠르게 작용하고 체내에서 신속하게 배출되기 때문에, 의료진은 반려동물의 안전과 편안함을 보장하기 위해 분 단위로 용량을 쉽게 조절할 수 있습니다.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.