Instruction for use: Dobutamin-Grindex

Active substance Dobutamine

ATX Code C01CA07 dobutamine

Pharmacotherapeutic group:

Cardiac glycosides and cardiac facilities neglikozidnye

Beta-adrenergic agonist

The nosological classification (ICD-10)

I50.0 Congestive heart failure

anasarca heart, Decompensated congestive heart failure, Congestive heart failure, Congestive heart failure with high afterload, Congestive chronic heart failure, Cardiomyopathy with severe chronic heart failure, Compensated chronic heart failure, Swelling with circulatory failure, Edema of cardiac origin, Swelling of the heart, Edematous syndrome in diseases of the heart, Edematous syndrome in congestive heart failure, Edematous syndrome in heart failure, Edematous syndrome in heart failure or liver cirrhosis, right ventricular failure, Congestive Heart Failure, Heart failure stagnant, Heart failure with low cardiac output, Heart failure is a chronic, Cardiac edema, Chronic decompensated heart failure, Chronic Congestive Heart Failure, Chronic heart failure, Change of liver function in heart failure

I50.1 Left ventricular failure

Asthma heart, Asymptomatic left ventricular dysfunction, Asymptomatic left ventricular heart failure, Diastolic left ventricular dysfunction, Left ventricular dysfunction, Changes in left ventricular myocardial infarction, Left ventricular heart failure, Left ventricular dysfunction, Acute left ventricular failure, Acute cardiac left ventricular failure, cardiac asthma, Left ventricular heart failure, Changes in left ventricular failure with pulmonary, Precordial abnormal pulsation, Insufficiency of the left ventricle

Structure and Composition

1 vial of 10 ml of a concentrated solution for infusion comprising 250 mg of dobutamine (as hydrochloride).

pharmachologic effect

pharmachological effect

cardiotonic.

Excited beta1-adrenergic receptors and causes a positive inotropic effect. It stimulates the beta 2-adrenergic receptors of the peripheral blood vessels and contributes to their expansion.

pharmacodynamics

Racemic mixture: dextrorotatory isomer has a beta1 and beta2-adrenomimeticheskoe and alpha-adrenoceptor blocking action and levo isomer - alpha adrenomimeticheskoe. It increases myocardial contractility, increased systolic and cardiac output. Decreases systemic vascular resistance and afterload on the myocardium, reduces elevated ventricular filling pressure and improves their function; facilitates atrioventricular conduction. As a result of the increase in cardiac output improves renal blood flow and renal function.

Pharmacokinetics

The action begins in 1-2 minutes after the administration, but to achieve a stable concentration for therapeutic effect full development takes about 10 min (depending on infusion rate). It is rapidly metabolized in the liver primarily by methylation of catechol-O-methyltransferase to form the active metabolites. T1 / 2 of 2 min. Write mainly in the urine and a small part - with the feces.

Indications of the drug dobutamin-Grindex

Acute and chronic decompensated heart failure (for short-term gain of myocardial contractility).

Contraindications

Hypersensitivity, idiopathic hypertrophic subaortic stenosis, cardiac tamponade, constrictive pericarditis, concomitant use with MAO inhibitors, hypovolemia, children's age (up to 3 years).

Pregnancy and breast-feeding

Perhaps if the expected effect of therapy outweighs the potential risk to the fetus. At the time of treatment should stop breastfeeding.

Side effects

From the nervous system and sensory organs: headache.

Cardio-vascular system and blood (blood, hemostasis): tachycardia, arrythmia, raising and lowering of blood pressure; rarely - chest pain, palpitations, respiratory failure.

From the digestive tract: nausea.

Allergic reactions: skin rash, fever, eosinophilia, bronchospasm.

Other: phlebitis (at the injection site), might be a slight hypokalemia.

Interaction

Halogenated agents for general anesthesia (cyclopropane, halothane) increase the risk of ventricular arrhythmias. Beta-blockers may reduce the effect, when combined with guanethidine may reduce the hypotensive effect guanetidina and an increase in the pressor effect of dobutamine. Simultaneous infusion of dobutamine and sodium nitroprusside or nitrates is accompanied by an increase in cardiac output and greater than the separate use of drugs, reducing the pressure in the capillaries.

Dosing and Administration

B / (continuous infusion) adults usually 2.5-10 ug / kg / min, but in some cases the dose may vary from 0.5 to 40 mg / kg / min. Treatment is usually started with a dose of 2.5 mcg / kg / min, increasing its every 10-30 minutes to achieve the desired therapeutic effect (under the control of heart rhythm and the central hemodynamics). Children - from 0.5 mcg / kg / min under the close supervision of hemodynamic parameters.

Overdose

Symptoms of anorexia, nausea, vomiting, irritability, tremor, palpitations, headache, bronchospasm, chest pain, hypertension, tachyarrhythmias, myocardial ischemia, ventricular fibrillation.

Treatment: cessation of drug administration, ensuring oxygenation and ventilation, with ventricular tachyarrhythmias used propranolol or lidocaine.

special instructions

Dilution of the concentrated solution using dobutamine 0.9% sodium chloride or 5% glucose solution. The prepared solution should be used within 24 ch.Obschy volume of injected solution should correspond to the needs of the patient in a liquid. If you want to restrict the flow of fluid in the body - introduced a more concentrated solution. To ensure accurate dosing dobutamine high concentration solution is injected only from an infusion pump.

You can not add to a solution of dobutamine alkaline solutions (sodium hydrogen carbonate, etc..). Because of possible physical incompatibilities dobutamine should not be mixed with other drugs in the same syringe.

Storageconditions

In the dark place at a temperature no higher than 25 ° C. Do not freeze.

Keep out of the reach of children.

The shelf life

2 years.

Do not use beyond the expiration date printed on the package.