Drugs: Dobutamine

Sympathomimedic (primarily for CHF)

IV piggyback

Adult: 2-20 mcg/kg per minute
Dilution ratio: 250mL, 500,mL or 1000mL may be added to various amounts 250mL, 500mL or 1000mL) of NS, D5W, or RL as determined by the clinical status and fluid requirements of the patient.

Pediatric: 2-20 mgc/kg titrated to desired effect.
Dilution ratio: 16.6
Contact medical control

Stimulates beta 1 receptors in the myocardium to increase myocardium contractility, stroke volume, and cardiac output.
Stimulates beta 2 receptors on the smooth muscle of the bronchioles and peripheral vessels to open airways and decrease peripheral vascular resistance (preload and afterload).
Has minimal alpha action, leaving blood vessels dilated.

Pulmonary adema with systolic B/P of 70-100 and no S/S of shock.

Do not administer through the same IV line with other drugs, especially Sodium Bicarbonate; refer to Drug Administration Principles.
Assure IV patency and administer through a large peripheral; refer to Drug Administration Principles.
Continously monitor heart rate, blood pressure, and ECG
Titrate so heart rate does not increase by more than 10 percent of baseline.

Phlebitis with infiltration
Tachycardia/tachy arrhythmias
In high doses - Nervousness, nausea vomiting, chest pain hypertension.

Suspected or known poison/drug induced shock
Systolic blood pressure less than 100 with signs/symptoms of shock
Concurrent beta-blocker use may antagonize.