Dobutamine: What’s it Used For?

22 January, 2020
Dobutamine is a drug used to treat severe heart failure, such as those triggered during cardiac surgery or in cases of septic shock.

Dobutamine is a drug with positive inotropic effects (see below). Therefore, it’s used to treat heart failure and cardiogenic shock, and is administered intravenously.

While dobutamine is structurally similar to dopamine and other catecholamines, this drug is a structural analog of isoprenaline and has different pharmacological properties, including the aforementioned inotropic effects, as well as chronotropic and vasodilation effects.

Unlike dopamine, dobutamine doesn’t affect dopamine receptors, although urine production may increase due to increased cardiac output, for example.

Inotropic and chronotropic effects?

A doctor holding a plastic heart.

The circulatory system has many key functions for proper bodily functioning. Among them, we can mention the following:

  • Transporting and distributing essential substances to tissues
  • Removing metabolic waste
  • Adjusting the supply of oxygen and nutrients in different physiological states
  • Body temperature regulation
  • Humoral communication

The heart has many characteristics you need to be aware of to understand how it works, as well as dobutamine’s mechanism of action. These are:

  • Automatism. The heart beats automatically.
  • Inotropic. The heart contracts under certain stimuli. The sympathetic nervous system has a positive inotropic effect. Therefore, it increases the heart’s ability to contract.
  • Chronotropism. Modification of the regularity of the heartbeat. The sympathetic nervous system produces tachycardia. In contrast, the parasympathetic nervous system decreases heart rate.
  • Batmotropism. Modifying the heart’s degree of excitability.
  • Chromotropism. The driving speed of cardiac impulses by a excito-conducting system. The sympathetic nervous system has a positive dromotropic effect Therefore, it increases conduction velocity. On the other hand, the parasympathetic nervous system has the opposite effect.
  • Lusitropy. The relaxation of the heart under certain stimuli.

Dobutamine indications

A digital recreation of the heart.

Dobutamine is a drug used to treat acute heart failure, such as those triggered during cardiac surgery or in cases of septic shock. All these effects are justified by the characteristic inotropic effects of this drug.

In addition, medical professionals can also prescribe dobutamine to patients who suffer from congestive heart failure in order to increase the heart’s performance. It’s often used in cases where the patient requires parenteral nutrition as inotropic support in the short-term treatment of cardiac decompensation due to a myocardium contractility deficiency.

Moreover, it’s important to mention that medical professionals don’t recommend dobutamine for treating coronary heart disease because it increases heart rate, which is accompanied by the myocardium’s consequent demand for oxygen.

Discover: What You Should Eat if You Suffered a Heart Attack

How does dobutamine trigger its effect on the body?

Dobutamine interacts with beta-1 adrenergic receptors, and activates them. Also, it has a lower alpha 1- and beta 2-adrenoceptor stimulation. Because of this, it’s able to increase myocardial contractility and stroke volume. Therefore, it triggers a series of modest chronotropic effects, causing increased cardiac output.

As a result of these effects, others occur at a hemodynamic level, such as a decrease in systemic vascular resistance and ventricular filling pressure. Furthermore, blood pressure also tends to increase due to increased stroke volume. However, diastolic blood pressure and mean arterial pressure usually remain unchanged.

As we mentioned at the beginning of the article, dobutamine has no effects on dopamine receptors, unlike this neurotransmitter. Also, it doesn’t cause the release of norepinephrine from sympathetic nerve endings.

You should also read: Heart Palpitations: 4 Reasons You Might Feel Them

Adverse effects of treatment with dobutamine

Many different pills on a flat surface.

Like any other drug on the market, dobutamine isn’t without side effects. We understand side effects as those undesirable and unintended events that a patient can expect when they start treatment with a drug.

Some of the side effects of this drug are:

  • Ventricular dysrhythmias
  • Hypertension
  • Increased systolic frequency
  • Nausea
  • Headache
  • Angina
  • Difficulty breathing

Conclusion

Dobutamine is a drug that medical professionals prescribe for the treatment of heart failure due to its ability to increase heart contractility and heart rate. However, it can trigger a series of adverse effects that the patient must assess with their doctor before starting treatment with this drug.

Consult a professional if you have any questions about dobutamine and tell them if you’re taking any other drugs. This way, you can avoid complications.

  • Claveria, J. (2016). Farmacos en Cardiología. Hospital Universitario Central de Asturias.
  • Levy, B., Perez, P., Perny, J., Thivilier, C., & Gerard, A. (2011). Comparison of norepinephrine-dobutamine to epinephrine for hemodynamics, lactate metabolism, and organ function variables in cardiogenic shock. A prospective, randomized pilot study. Critical Care Medicine. https://doi.org/10.1097/CCM.0b013e3181ffe0eb
  • Mraz, S., & Rorabaugh, B. (2007). Dobutamine. In xPharm: The Comprehensive Pharmacology Reference. https://doi.org/10.1016/B978-008055232-3.61634-4