Naming:
- X: implies speed (very short half-life) => DOBUTrex
- -amine: belonging to catechol-amine groups
-DOBUTamine: tall man system to differentiate it from DOPamine.
- I have tried but unable to figure out how dobutamine was named dobutamine. Original article Dobutamine development: http://circres.ahajournals.org/content/36/1/185.full.pdf+html
Mnemonics: doButamine => duh a Butt => duh a = alpha1; B1 (a butt) B2 (two cheeks)
Clinical use: mostly for heart failure
Physiology & Pharmacology & clinical use:
- Partial agonists on B1, B2 adrenoceptors with little effects on A1 adrenoceptors (3)
- Unlike Dopamine, Dobutamine (Dobutrex) does NOT bind to dopamine receptors. Therefore, it does NOT increase renal blood flow as Dopamine does (1). => use dopamine to help your kidneys esp. in shock so that your kidneys don't die.
- "synthesized to have potent inotropic activity without peripheral vascular effect. " (4)
=> synthetic drug selected specifically for heart rate contractility but does NOT cause vasoconstriction. Esp: stress test => you don't want to use NorEpi, Dopamine, or Epi bc blood pressure will go up. And, you don't want to do that to this person. You just want the heart rate up but NOT for blood pressure. So you can use DOBUTamine for this. (my bf's)
- Super short half-life (<5min) makes it ideal for critical care setting. Thus its steady state is achieved within 10-15min during infusion (3-5 half-life). (2)
Comparison:
- Compared with DOPamine: DOBUTamine differs in that it's completely similar to DOPamine but with a bulky aromatic group (2)
- ICU: Dobutrex & NorEpi used concurrently to treat sepsis (shock with low cardiac output) to maintain MAP & tissue perfusion (3)
Clinical pearls:
- at high dose, dobutamine starts to have strong beta2 effects
(1): https://books.google.com/books?id=45DKiUj1hLUC&pg=PA86&dq=DOBUTAMINE&hl=en&sa=X&ved=0ahUKEwjuuaXewPvLAhVC0WMKHe22ByIQ6AEIJjAC#v=onepage&q=DOBUTAMINE&f=false
(2) https://books.google.com/books?id=45DKiUj1hLUC&pg=PA86&dq=dobutamine&hl=en&sa=X&ved=0ahUKEwiHtrOU4PvLAhUB_2MKHTlFA-IQ6AEIJTAC#v=onepage&q=dobutamine&f=false
(3): https://books.google.com/books?id=XkKn96HThzEC&pg=PA1725&dq=DOBUTAMINE&hl=en&sa=X&ved=0ahUKEwj8zMXQwvvLAhUL62MKHaMEDPI4ChDoAQgmMAI#v=onepage&q=DOBUTAMINE&f=false
(4): https://books.google.com/books?id=pcHuRboVuXUC&pg=PA661&dq=dobutamine&hl=en&sa=X&ved=0ahUKEwjj8q7u1vvLAhUFr4MKHebOBMEQ6AEIQzAI#v=onepage&q=dobutamine&f=false
(5) http://www.globalrph.com/icu-agents.htm
(6): http://reference.medscape.com/drug/intropin-dopamine-342435
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