Doʙutamin

When ATH:
C01CA07

Pharmacological action.
Cardiac.

Application.

Acute heart failure (acute myocardial infarction, cardiogenic shock), exacerbation (acute decompensation) chronic Heart Failure, congestive heart failure (as a temporary adjuvant against the main therapy), low cardiac output (as a collateral phenomenon in residual positive pressure VENTILATION breathing out).

Contraindications.

Hypersensitivity, idiopathic hypertrophic stenosis subaortalnыy.

Restrictions apply.

Cardiac tamponade, perikardit, gipertroficheskaya obstruktivnaya cardiomyopathy, aortic stenosis, gipovolemiя, simultaneous MAO inhibitors, pregnancy, lactation, childhood.

Pregnancy and breast-feeding.

When pregnancy is possible, if the effect of therapy outweighs the potential risk to the fetus (adequate and well-controlled studies of the safety of use in pregnant women were not conducted). At the time of treatment should stop breastfeeding (unknown, whether dobutamine in breast milk).

Side effects.

Cardio-vascular system and blood (hematopoiesis, hemostasis): tachycardia (incl. Ventricular), atrial fibrillation, pain in the chest and heart, heartbeat, breathlessness, Ad/hypotension, kaliopenia, inhibition of platelet aggregation (prolonged use), petehiale bleeding.

Allergic reactions: skin rash, fever, bronchospasm, eozinofilia, etc.).

Other: headache, nausea, polyuria (when administered at high doses); phlebitis, in some cases, necrosis of the skin (at the injection site).

Cooperation.

Beta-adrenoblokatora reduce the positive effect inotropony. There is a marked falls round and increased cardiac output when combined with sodium nitroprusside or nitrates, than separate appointment. Together with the use of MAO inhibitors are possible hypertonic Kriz, collapse, irregular heartbeat. Halogenated anaesthetic (halothane etc.) increase the risk of ventricular arrhythmia. Farmatsevticeski incompatible with alkaline solutions, incl. from 5% solution of sodium bicarbonate, with solutions, containing ethanol, sodium bisulfite. Due to the potential for pharmaceutical incompatibility is not recommended to mix dobutamine with other solutions in one sprite.

Overdose.

Symptoms: anorexia, nausea, vomiting, tremor, alarm, heartbeat, headache, breathlessness, angina or cardialgia, integuments, severe hypertension, myocardial ischemia.

Treatment: speed reduction or cessation of the drug, ensure ventilation and oxygenation of the blood, When ventricular tahiaritmii apply propranolol or lidocaine.

Dosing and Administration.

B /, drop (preferably using infusion pump), adults usually 2.5-10 (Optionally, 20-40) ug / kg / min. The dose is determined individually.

The required dose for children should be calculated taking into account the lesser, than in adults, breadth of therapeutic action.

Precautions.

Prior to the introduction of a correction of hypovolemia by transfusion of whole blood or plasma substitutional liquids. During treatment required constant monitoring of HELL, ventricular filling pressure, central venous pressure, pressure in the pulmonary artery, Heart Rate, ECG, stroke volume, body temperature and diuresis. Welcome to monitor the level of potassium in the blood serum. When treating patients with diabetes need to monitor the level of glucose in the blood.

Cautions.

In the continued use of the drug more 72 h may develop tolerance (It is necessary to increase the dose). If there are mechanical barriers for filling of the ventricles (vices, cardiac tamponade, perikardit) and/or outflow of blood from the cefuroxim calls improve hemodynamics. When cardiac tamponade, valvular aortic stenosis, subaortalinom stenosis may develop paradoxical reactions (decreased cardiac output).

Cooperation