Dobutamine (dobutrex, others) is indicated for the short-term treatment of cardiac decompensation post cardiac surgery or in patients with congestive heart failure or acute myocardial infarction. An infusion of dobutamine in combination with echocardiography is useful in the noninvasive assessment of patients with coronary artery disease; stressing the heart with dobuta-mine may reveal cardiac abnormalities in selected patients.
A loading dose is not required, and steady-state concentrations generally are achieved within 10 minutes of initiation of the infusion. The rate of infusion required to increase cardiac output typically is 2.5—10 mg/kg/min; higher infusion rates occasionally are required. The rate and duration of the infusion are determined by the clinical and hemodynamic responses of the patient. The onset of effect is rapid. Dobutamine has a t122 of -2 minutes; the major metabolites are conjugates of dobutamine and 3-O-methyldobutamine.
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