Autonomic Nervous System Regulation
4.12 Beta-1 Agonists
Dobutamine is a Beta-1 agonist.
Mechanism of Action: Dobutamine stimulates Beta-1 receptors to increase heart rate, force of contraction, and conduction velocity.
Indications for Use: Dobutamine is used to treat cardiogenic shock and severe heart failure to increase contractility and cardiac output.
Nursing Considerations Across the Lifespan: Beta-1 agonists can safely be administered to pediatric clients, but doses must be adjusted according to weight. These medications are also safe in the older adult population, with no special dose adjustments for renal or liver insufficiency. Beta-1 agonists should not be given in pregnancy, if they can be avoided.
In IV administration, dilute concentration before administering. Continuously monitor electrocardiogram (ECG), blood pressure, cardiac output, and urine output during therapy. This drug can cause a marked increase in heart rate and blood pressure. Report all adverse reactions promptly, especially laboured breathing, angina, palpitations, and dizziness.
Patient Teaching & Education: The client should be instructed to inform the nurse immediately if they notice chest pain, shortness of breath, or numbness or tingling in the extremities.[1]
Dobutamine Medication Card
Now let’s take a closer look at the medication card for dobutamine.[2][3] Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication.
Medication Card 4.12.1: Dobutamine
Class: Beta-1 Agonist
Prototypes: Dobutamine
Therapeutic Effects
- Increases heart rate, force of heart contraction, and speed of conduction between SA to AV nodes
Administration
- IV only
- Must be administered with infusion device
- Following IV administration, the onset of action of dobutamine occurs within 2 minutes. Peak plasma concentrations of the drug and peak effects occur within 10 minutes after initiation of an IV infusion.
- Continuously monitor ECG, blood pressure, cardiac output, and urine output during therapy
Indications
- treat cardiogenic shock and severe heart failure to increase contractility and cardiac output
Side Effects
- marked increase in heart rate and blood pressure
- headache
- nausea
- dyspnea
Nursing Considerations
- Report all adverse reactions promptly, especially labored breathing, angina, palpitations, and dizziness
- monitor vital signs closely (client must be on continuous ECG monitoring)
- uCentral from Unbound Medicine. https://www.unboundmedicine.com/ucentral ↵
- This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain. ↵
- UpToDate (2021). Dobutamine. https://www.uptodate.com/contents/search ↵