DOBUTAMINE

• Inotropic support in low output cardiac failure associated with myocardial infarction, cardiogenic shock
• Before commencing dobutamine, seek advice from cardiology team
• Dobutamine hydrochloride is contraindicated in septic shock

• Dobutamine hydrochloride 250 mg in 20 mL vials

• Sodium chloride 0.9% or glucose 5%
• Dobutamine hydrochloride is incompatible with sodium bicarbonate and other strongly alkaline solutions
• IV solutions prepared as below are stable for 24 hr at room temperature
• the solutions may turn pink and the colour may intensify with time

• Administer dobutamine through a central line, if available
• Give Dobutamine peripherally only on the advice of a consultant
• use a large vein high up in a limb, preferably the arm, in order to reduce risk of tissue necrosis
• administer the 2 mg/mL solution in a minibag only

• Start with continuous IV infusion 0.5–10 mcg/kg/min, adjusted according to response
• Monitor heart rate and rhythm, BP, cardiac output (if possible), and urine output
• if no response, seek advice of cardiology team before increasing dose further

Infusion via syringe pump

• ONLY via central line
• Use a 50 mL syringe to make up 250 mg dobutamine (20 mL) to 50 mL with diluent (see Diluents)
• 250 mg in 50mL syringe=5 mg/mL

Syringe (5mg/mL) rate for selected dose

• Give ONLY through a central line

Minibag infusion via controlled-infusion device

• Via a peripheral vein or central line
• Withdraw 40 mL from a 250 mL bag of diluent (see Diluents)
• Add two 250 mg vials of dobutamine (40 mL) to the bag and mix well
• 500 mg in 250 mL minibag = 2 mg/mL

• Decrease dosage gradually by small decrements according to response