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Action/Kinetics:
Stimulates beta-1 receptors (in the heart), increasing cardiac function, CO, and SV, with minor effects on HR. Decreases afterload reduction although SBP and pulse pressure may remain unchanged or increase (due to increased CO). Also decreases elevated ventricular filling pressure and helps AV node conduction.
Onset: 1-2 min.
Peak effect: 10 min.
t
1/2: 2 min.
Therapeutic plasma levels: 40-190 ng/mL. Metabolized by the liver and excreted in urine.
Uses:
Short-term treatment of cardiac decompensation in adults secondary to depressed contractility due to organic heart disease or cardiac surgical procedures.
Investigational: Congenital heart disease in children undergoing diagnostic cardiac catheterization.
Contraindications:
Idiopathic hypertrophic subaortic stenosis.
Special Concerns:
Safe use during childhood or after AMI not established.
Side Effects:
CV: Marked increase in HR, BP, and
ventricular ectopic activity precipitous drop in BP, premature ventricular beats, anginal and nonspecific chest pain, palpitations.
Hypersensitivity: Skin rash, pruritus of the scalp, fever, eosinophilia,
bronchospasm.
Other: Nausea, headache, SOB, fever, phlebitis, and local inflammatory changes at the injection site.
Overdose Management:
Symptoms: Excessive alteration of BP, anorexia N&V, tremor, anxiety, palpitations, headache, SOB, anginal and nonspecific chest pain,
myocardial ischemia, ventricular fibrillation or tachycardia.
Treatment: Reduce the rate of administration or discontinue temporarily until the condition stabilizes. Establish an airway, ensuring oxygenation and ventilation. Initiate resuscitative measures immediately. Treat severe ventricular tachyarrhythmias with propranolol or lidocaine.
Additional Drug Interactions:
Concomitant use with nitroprusside causes
CO and
PAWP.
How Supplied:
Injection: 12.5 mg/mL
Dosage
?IV Infusion
Adults, individualized, usual: 2.5-15 mcg/kg/min (up to 40 mcg/kg/min). Rate of administration and duration of therapy depend on response of client, as determined by HR, presence of ectopic activity, BP, and urine flow.
