多巴酚丁胺
Dobutamine
Dobutamine HCl
別名: Dobutrex · Posiject · 46236 · compound 81929 · dobutamini hydrochloridum · LY-174008 · Dobutamina · Dobutaminum
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
經審核的 v13 劑量證據
結構化劑量計算證據Hypotension during general anesthesia (extra-label)
須由已驗證獸醫確認
NA
必須同時考慮的臨床上下文 (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.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
多巴酚丁胺 (Dobutamine) 是一種合成的兒茶酚胺，為快速作用的注射型正性肌力藥物。
主要臨床特點包括：
- 主要用途： 用於急性心臟衰竭（如擴張性心肌病）和心因性休克的短期治療。
- 血流動力學支持： 當單獨使用輸液治療無法恢復可接受的動脈血壓、心輸出量或組織灌注時使用。
- 臨床要點： 由於其半衰期極短，必須在密切監測的加護病房 (ICU) 環境中以連續靜脈輸注 (CRI) 的方式給藥。與多巴胺不同，多巴酚丁胺不依賴內源性去甲腎上腺素的釋放，因此在兒茶酚胺耗竭的衰竭心臟中更為可靠。
作用機制
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.
安全性與警告
禁忌症
- Known hypersensitivity to dobutamine or the preservative sodium bisulfite
- Idiopathic hypertrophic subaortic stenosis (IHSS)
- Uncorrected hypovolemic states
- Cardiac outflow obstruction (e.g., aortic stenosis)
不良反應
- 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.
藥物相互作用
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
監測
- 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
藥物動力學
半衰期
吸收
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.
分佈
It is unknown if dobutamine crosses the placenta or into milk.
代謝
Metabolized rapidly in the liver and other tissues.
排除
The drug's effects diminish rapidly after cessation of therapy.
過量
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.
可用產品
劑型
- Injection Concentrated Solution
- Solution for Injection
- Injectable: 12.5 mg/ml solution
- Injectable: 50 mg/ml solution
獸醫用
- Dobutamine 12.5 mg/ml injectable solution
- Dobutamine 50 mg/ml injectable solution
人用標示
- 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)
各地核准狀態
POM (Prescription Only Medicine)
POM-V
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Dobutamine injection should be stored at room temperature (15-30°C); diluted solutions should be used within 24 hours.
飼主須知
注意： 多巴酚丁胺嚴格來說是一種重症加護藥物，不會開立處方供居家使用。
- 用途： 此藥物透過連續靜脈 (IV) 點滴給藥，幫助您的寵物在危重疾病、休克或嚴重心臟衰竭危機期間，讓心臟更有效地泵血。
- 監測： 您的寵物將留在加護病房 (ICU)，獸醫專業人員會持續監測其心跳速率、心電圖和血壓。
- 安全性： 由於該藥物作用非常快且迅速排出體外，獸醫團隊可以每分鐘精確調整劑量，以確保您寵物的安全與舒適。
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