(LifeWire) - When patients are hospitalized because of heart failure, their deteriorating condition requires quick action to strengthen cardiac output and stabilize blood flow. Dobutamine is a generic drug often used in such crises because of its ability to rapidly boost the pumping action of the heart.
Classified as an inotrope, a compound that affects the force of muscle contractions, dobutamine is given intravenously, usually in a hospital setting, and often to critically ill patients with heart failure who are in danger of dying. This situation, called acute decompensated heart failure, causes nearly 1 million hospitalizations each year in the United States and kills half of all patients suffering from the condition.
Heart failure is the inability of the heart to pump as efficiently as normal and in itself claims about 350,000 lives annually and affects about 5 million Americans; there are numerous causes, including high blood pressure, diabetes or other cardiac conditions, such as valve problems or prior heart attack.
Symptoms of heart failure, a chronic condition with no cure, include shortness of breath, fatigue, coughing and edema, the buildup of fluid in several parts of the body, including the lungs.
Dobutamine is sometimes offered to stabilize patients with heart failure, who receive it through an intravenous catheter as outpatients, to help manage day-to-day symptoms. But it's primarily used for more severely ill patients. Some patients hospitalized after cardiac surgery, such as coronary artery bypass surgery, also receive dobutamine postoperatively to boost diminishing blood flow by increasing heart contractions.
Despite the use dobutamine to quickly alleviate heart failure symptoms, a significant number of patients with acute heart failure on dobutamine die within 6 months of hospitalization. Scientists in the Journal of the American Medical Association, who in 2007 compared dobutamine to another heart failure drug called levosimendan, found that the all-cause mortality rate within 180 days for patients on these drugs was about 25%.
Side effects of dobutamine are typically minimal because the drug has a short-working cycle, but they can include:
- A significant change in blood pressure
- Allergic-type reactions, such as trouble breathing
- Chest pain
- Shortness of breath
- Heart palpitations
- Skin rash
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Mebazaa, Alexandre, Markku S. Nieminen, Milton Packer, Alain Cohen-Solal, Franz X. Kleber, Stuart J. Pocock, Roopal Thakkar, Robert J. Padley, Pentti Poder, and Matti Kivikko. "Levosimendan vs. Dobutamine for Patients With Acute Decompensated Heart Failure: The SURVIVE Randomized Trial." Journal of the American Medical Association 297:17(2007): 1883-91. 1 Dec. 2008 <http://jama.ama-assn.org/cgi/content/abstract/297/17/1883>.
Rodgers, Jo E. "Acute Decompensated Heart Failure: Review of Pathophysiology and Key Clinical Trials." ashp.org. 2006. American Society of Health-System Pharmacists. 1 Dec. 2008 <http://symposia.ashp.org/adhfseries/83/podcast_handout.pdf>.