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 Conjugation
 Elimination;
 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
Tremor
Restlessness
Feeling of anxiety
 Cardiovascular system;
 Increase in heart beat by >30 beats/min.
 Vasoconstriction
 Anginal pain
 Tachycardia
 Renal;
 Urinary urgency
 Respiratory;
 Shortness of breath
 GIT;
 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 
Drug profile of dobutamine

Drug profile of dobutamine

  • 1.
    DRUG PROFILE PRESENTED BY: SYEDAZAHRA AZIZ DOBUTAMINE
  • 3.
  • 4.
    INTRODUCTION; Name of drug; Dobutamine (generic name)  Dobutrex (trade name) Class of drug; Sympathomimetic (beta-1 agonist) Vasopressor
  • 5.
    STRUCTURE OF DOBUTAMINE; (SYNTHETIC CATECHOLAMINE)
  • 6.
  • 7.
  • 8.
    PHARMACODYNAMIC PROPRTIES  MECHANISMOF ACTION;  Directly stimulates beta adrenergic receptor.  Stimulation of Adenyl cyclase activity.  Doesn‘t cause release of nor epinephrine.  Cardiac Stimulation.
  • 9.
     Positive inotropiceffect on myocardium.  Increase in cardiac output.  Decrease in peripheral resistence.  Increased myocardial Oxygen consumption.  Increase in urine flow.  Doesn‘t affect Dopaminergic receptor.
  • 10.
    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 Conjugation  Elimination;  Plasma half-life is 2 min  Excretion mainly through urine.
  • 11.
    INDICATIONS;  Inotropic support Cardiac failure  Open heart surgery  Positve end expiratory pressure  Alternative to exercise in Cardiac stress testing.
  • 12.
    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.
  • 13.
    CONTRAINDICATIONS;  Hypersensitivity todobutamine.  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
  • 14.
    ECHOCARDIOGRAPHY; In this technique,heart disease is detected by using sound waves and this will generate image of heart.
  • 15.
    OVERDOSAGE; Symptoms;  Anorexia  Nausea,vomiting, tremor  Headache, chest pain  Excessive Hypertention  Tachycardia
  • 16.
    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.
  • 17.
    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.
  • 18.
     Metabolism andnutrition disorder;  Hypokalemia  Central Nervous System; Headache Tremor Restlessness Feeling of anxiety
  • 19.
     Cardiovascular system; Increase in heart beat by >30 beats/min.  Vasoconstriction  Anginal pain  Tachycardia  Renal;  Urinary urgency  Respiratory;  Shortness of breath  GIT;  nausea
  • 20.
    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.
  • 21.
     Rate ofadministration 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.
  • 22.
    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
  • 23.
    H 2- Antagonist (cimitidine);  Significance; 4  Onset; rapid  Severity; moderate  Documentation; possible  Effects; increased hypertention  Mechanism; unknown  Managment; monitor blood pressure and adjust dobutamine dose.
  • 24.
     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.
  • 25.
     Pregnancy andlactation;  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.
  • 26.
     Lab testinterferences;  None well documented
  • 27.
     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.
  • 28.
    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”
  • 29.
    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.
  • 30.
    PATIENT AND FAMILYEDUCATION;  Instruct patient to report these symptoms to physician and Pharmacist ;  Pain or discomfort at IV site  Any anginal pain
  • 31.
  • 32.
    PATIENT SHOULD CONSULTHIS PHYSICIAN AND PHARMACIST FOR SAFE USE OF MEDICATION;
  • 33.
     I believethat; PREVENTION IS BETTER THAN CURE
  • 34.
    Keep ur mind,heart,body and soul healthy;
  • 35.
    Make ur lifestyle healthier;
  • 40.
  • 41.