Anaes SAQs · Anaesthetic adjuncts

Dobutamine and dopamine — pharmacology and clinical use

Final SAQ — dobutamine (the synthetic beta-1 inotrope; vasodilating at clinical doses, taught pharmacology; less tachyarrhythmia than dopamine or adrenaline; cardiogenic shock and dobutamine stress echocardiography, prognostic cohort-exact 166 patients and 20% events, Dippenaar 2026) contrasted with dopamine (the natural noradrenaline precursor; direct plus indirect action; dose-dependent D1 at 1 to 3 mcg per kg per min, beta-1 at 3 to 10 mcg per kg per min, alpha-1 above 10 mcg per kg per min — taught tiers; the porcine cord-perfusion study owns no dosing claim, Routkevitch 2026); renal-dose dopamine DISPROVEN trial-exact (328 patients, Bellomo 2000); dopamine more arrhythmogenic and raises PVR (taught pharmacology); neonatal septic shock compared option with no superiority (4-RCT null, Yahya 2026); both short half-life about 2 minutes, COMT, tachyphylaxis after 48 to 72 hours (taught pharmacology), extravasation necrosis reversed by phentolamine (cohort-exact 31 of 3734, 0.8%, Shyu 2025); delirium null in older adults (OR 0.97, P 0.9065, Dong 2026).