is a sympathomimetic drug
used in the treatment of heart failure
and cardiogenic shock
. Its primarcy mechanism is direct stimulation of β1 receptors
of the sympathetic nervous system
. It was developed by a laboratory led by Dr. Ronald Tuttle at Eli Lilly & Company
Dobutamine is used to treat acute but potentially reversible heart failure
, such as cardiac surgery
or cases of septic
or cardiogenic shock, on the basis of its positive inotropic
Dobutamine can be used in cases of congestive heart failure to increase cardiac output. It is indicated when parenteral therapy is necessary for inotropic support in the short-term treatment of patients with cardiac decompensation due to depressed contractility, which could be the result of either organic heart disease or cardiac surgical procedures. It is not useful in ischemic heart disease because it increases heart rate and thus increases the heart's demand for oxygen.
Dobutamine is a direct-acting agent whose primary activity results from stimulation of the β1-adrenoceptors
of the heart, increasing contractility and cardiac output. Since it does not act on dopamine receptors
to induce the release of norepinephrine
agonist), dobutamine is less prone to induce hypertension than is dopamine
, arrhythmogenic, and vasodilative effects are negligible.
Dobutamine is predominantly a β1-adrenergic agonist, with weak β2 activity, and α1 selective activity, although it is used clinically in cases of cardiogenic shock for its β1 inotropic effect in increasing heart contractility and cardiac output. Dobutamine is administered as a racemic mixture consisting of both (+) and (−) isomers, and the (+) isomer is a potent β1 agonist while the (−) isomer is a α1 agonist. Dobutamine also has mild β2 agonist activity.
Primary side effects include those commonly seen for β1 active sympathomimetics, such as hypertension, angina, arrhythmia, and tachycardia.