DRUG PROFILE

PRESENTED BY:

SYEDA ZAHRA AZIZ

DOBUTAMINE

DOBUTAMINE(Myocardiac stimulant)

INTRODUCTION;Name of drug; Dobutamine (generic name)Dobutrex (trade name)

Class of drug;Sympathomimetic (beta-1 agonist)

Vasopressor

STRUCTURE OF DOBUTAMINE;( SYNTHETIC CATECHOLAMINE)

PHARMACEUTICAL FORM; STERILE INJECTION

QUALITATIVE AND QUANTITAVE COMPOSITION;

PHARMACODYNAMIC PROPRTIES

MECHANISM OF ACTION;

Directly stimulates beta adrenergic receptor.

Stimulation of Adenyl cyclase activity.

Doesn‘t cause release of nor epinephrine.

Cardiac Stimulation.

Positive inotropic effect on myocardium.

Increase in cardiac output.

Decrease in peripheral resistence.

Increased myocardial Oxygen consumption.

Increase in urine flow.

Doesn‘t affect Dopaminergic receptor.

PHARMACOKINETIC PARAMETERS;Absorption; Following IV administration Onset of action is 2 min Peak plasma conc. of drug is 10 min after initiation

of an IV infusion.Distribution;Metabolism; ( in liver) Methylaion and ConjugationElimination; Plasma half-life is 2 min Excretion mainly through urine.

INDICATIONS; Inotropic support

Cardiac failure

Open heart surgery

Positve end expiratory pressure

Alternative to exercise in Cardiac stress testing.

CARDIAC STRESS TESTING;

It is a test used in medicine and cardiology to measure Heart‘s ability to respond to the external stress in a controlled clinical environment.

CONTRAINDICATIONS; Hypersensitivity to dobutamine. Pheochromocytoma Must not be used in myocardial ischemia,

in case of ; Recent myocardial infarction, Unstable angina pectoris, Stenosis of main left coronary artery, Heart failure

ECHOCARDIOGRAPHY;

In this technique, heart disease is detected by using sound waves and this will generate image of heart.

OVERDOSAGE;

Symptoms; Anorexia

Nausea, vomiting, tremor

Headache, chest pain

Excessive Hypertention

Tachycardia

MANAGMENT OF TOXICITY; The initial action to be taken;

Discontinuing administration of drug. Ensuring oxygenation and ventilation. If product is ingested , then absorption

of drug from GIT may be decreased by giving activated charcoal. It is better than emesis and gastric lavage.

ADVERSE DRUG REACTION; Immune system disorders;

Hypersensitivity reactions including; rash fever Anaphylactic reactions and severe life-

threatening asthmatic episodes may be due to sulphite sensitivity.

Metabolism and nutrition disorder;

Hypokalemia

Central Nervous System;

Headache

TremorRestlessnessFeeling of anxiety

Cardiovascular system; Increase in heart beat by >30 beats/min. Vasoconstriction Anginal pain TachycardiaRenal; Urinary urgencyRespiratory; Shortness of breathGIT; nausea

POSOLOGY AND ROUTE;

Route; For IV use only Because of its shorter half life it is

administered as continuous IV infusion. Dilutions Dosage of adult and the elderly; 2.5-10 mcg/kg/min 0.5mcg/kg/min Rarely upto 40mcg/kg/min may be

required.

Rate of administration and duration of therapy should be adjusted according to patient response, as determined by measurement of;

Heart rate Blood pressure Urine flow

Children; Safety and efficacy of dobutamine therapy

in children have not been established.

INTERACTIONS;

Halogenated anesthesia;Desflurane; Onset : rapid Severity: major Documentation: possible Effect; death due to cardiac ischemia Mechanism; unknown Managment; this has not proven because of

its severity,the possiblity of this drug be considered

H 2- Anta gonist (cimitidine);

Significance; 4 Onset; rapid Severity; moderate Documentation; possible Effects; increased hypertention Mechanism; unknown Managment; monitor blood

pressure and adjust dobutamine dose.

Rauwolfia alkaloid ( Reserpine);Significance; 2 Onset; rapid Severity; moderate Documentation; suspected Effect; it potentiate pressor response of

dobutamine and results in incresed hypertention

Mechanism; it depletes stores of catecholamines, increasing receptor sensitivity to dobutamine.

Pregnancy and lactation; Category; B Reproduction studies in rats and rabbits

have revealed no evidence of impaired fertility, harm to the foetus, or teratogenic effects due to dobutamine. As there are no adequate and well-controlled studies in pregnant women, and as animal reproduction studies are not always predictive of human response, dobutamine should not be used during pregnancy unless the potential benefits out weigh the potential risks to the foetus.

Lab test interferences;

None well documented

Precautions ; Use with extreme caution after

myocardial ischemia Dose is decreased if there is undue

increase in heart rate, systolic blood pressue or arrythmia is precipitated.

Mild hypokalemia may occur.Sulphite sensitivity; Use with caution in sulphite – sensitive

patients because it causes allergy.

PATIENT CARE CONSIDERATION; Administration and storage;

Administration only by IV infusion.

Carton text shall contain the following statements:

 “Dilute to at least 50 ml volume before intravenous infusion”

 

if not required immediately, the diluted solution may be stored for up to 24 hours in a refrigerator.”

 

Keep out of the reach of children 

“If only part used, discard the remaining solution” 

“Protect from light”

“Do not store above 25°C”

ASSESSMENT AND INTERVENTION;

Obtain pt. History Monitor vital signs , ECG,

cardiac output, urinary output etc

Monitor potassium level Monitor placement of IV

catheter to reduce risk of extravasation. If pt. has diabetes then

monitor blood glucose level and then report to physician.

PATIENT AND FAMILY EDUCATION;

Instruct patient to report these symptoms to physician and Pharmacist ;

Pain or discomfort at IV site

Any anginal pain

COUNCELLING WITH PATIENT ;

PATIENT SHOULD CONSULT HIS PHYSICIAN AND PHARMACIST FOR SAFE USE OF MEDICATION;

I believe that;

PREVENTION IS BETTER THAN CURE

Keep ur mind, heart,body and soul healthy;

Make ur life style healthier;

Any Question ?

Thanks again all of you