Let’s face it: Dopamine and Dobutamine can be a bit confusing! This podcast covers these two medications and helps to dispel the confusion around these two meds. One is an inotrope while the other is an alpha agonist. So if you are worried about Dopamine vs Dobutamine . . . we’ve got you covered.
Due to these two key differences these medications are used for different reasons and have different actions within the body. Which one do you use for Heart Failure, which one for Septic Shock? I have posted a cheat sheet at NRSNG.com/Dopamine . . check it out!
|Hey, Jon here within nrsng.com. Be sure to check us out online at nrsng.com, our YouTube channel, our YouTube username is nrsgncom. We appreciate you listening. Today we’re going to talk about Dopamine versus Dobutamine. There’s some confusion with people about Dopamine and Dobutamine probably because of the name sounding so familiar and that they can be used in similar situations. Let’s talk about what the difference is between Dopamine and Dobutamine.|
|First of all, it’s important to understand that Dopamine is a vasopressor, and Dobutamine is not a vasopressor, Dobutamine is actually a positive inotropic drug and it is not a vasopressor. Dopamine, vasopressor, Dobutamine, is an inotrope not a vasopressor.|
|Dobutamine actually exhibits primarily beta 1 effects to aid an increasing cardiac output. We remember that on our heart we have beta 1 receptors, and as those receptors are stimulated, we’re going to have a positive inotropic effect. What that means is a positive, an increase in the squeeze of the heart and that’s going to lead to increased cardiac output. That’s the reason we give beta-blockers is to block those beta 1 receptors like Metoprolol and things like that that’s going to lower our heart rate and have a subsequent decrease in blood pressure as well.|
|What Dobutamine does it has the reverse effect of that. It actually stimulates the beta 1 receptors, and that leads to an increase in cardiac output. The way I remember that is Dobutamine has a B in it like beta, so you can think of Dobutamine beta, B B, and that’s going to have that positive beta 1 effect and lead to the increase in cardiac output.|
|Dopamine on the other hand, depending on the dosage will exhibit alpha 1 effects, which leads to vasoconstriction and increase systemic vascular resistance. In lower doses, Dopamine will actually also exhibit a beta 1 effect that leads to the increase in heart rate at those lower doses, but primarily, Dopamine is an alpha adrenergic agonist. You remember that the alpha 1 receptors, what they will do is they’ll increase the squeeze of the vessels to lead to vasocontriction, so Dopamine is going to have that alpha effect, it’s going to squeeze the vessels down, cause that vasocontriction, and because of that, our blood pressure is going to go up as we increase that systemic vascular resistance.|
|Dobutamine, beta effect, increase inotropic effect, increase squeeze of the hearth. Dopamine, alpha effect, increase vasocontriction. For this reason Dopamine is a great medication in septic shock, because with septic shock we have that increased vasodilation with sepsis in septic shock. If we give Dopamine during septic shock we can increase that systemic vascular resistance, the squeeze to help counter that effect of septic shock.|
|Dobutamine is generally given to increase cardiac output. It’s used in heart failure and cardiogenic shock. It’s a drug of choice to increase cardiac output as it does not necessarily increase our heart rate at lower doses, and because of that it’s going to have less myocardial oxygen demand, it’s going to lead to less myocardial oxygen demand, and so it works really great in heart failure and things like that.|
|That’s basically the difference between the two. The best way, like I said, to remember it is with Dobutamine it’s got that B in it, remember it as a beta 1 agonist, and Dopamine on the other hand is an alpha agonist, it’s going to lead to the constriction of the vessels, Dobutamine is going to lead to increased cardiac output and increased inotropic effect of the heart.|
|We’re going to have a chart up on nrsng.com, we’re going to have that at nrsng.com and you can find it under Dopamine. If you go there you’ll be able to find this chart, free download under Dopamine, nrsng.com/dopamine, and you’ll be able to find it. It talks about all the differences between Dopamine and Dobutamine, it has a nice graph of all the different hemodynamic effects of these two different drugs. It also takes some of the different vasoconstrictors, vasoactive medications and list them in order of how much they increase systemic vascular resistance and what effect they have on cardiac output as well.|
|If you go to nrsng.com/dopamine, you’ll be able to find that chart. Find us on YouTube and send us any questions you have.|
Date Published - Sep 18, 2017
Date Modified - Sep 16, 2017