Drugs Five Years Later

Abstract

Dobutamine is a synthetic catecholamine developed as a relatively selective positive inotropic drug for short-term parenteral administration. Dobutamine's effects are mediated by strong beta₁ adrenergic receptor stimulation and mild stimulation of beta₂ and alpha₁ receptors. Dobutamine should be used to improve ventricular function and cardiac performance in patients in whom ventricular dysfunction has caused a reduced stroke volume and cardiac output, a mild to moderate drop in systemic blood pressure, diminished organ and tissue perfusion, and elevated ventricular filling pressures. When guidelines for patient selection and dosing are adhered to, ventricular dysfunction and cardiac decompensation secondary to atherosclerotic occlusive coronary artery disease can be improved without adversely affecting the myocardial oxygen supply and demand balance. Dobutamine has less vasopressor activity than norepinephrine and dopamine, and should not be the primary treatment in conditions characterized by marked hypotension and shock.