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Last Week:
Dobutamine

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RxMnemonic Cardiovascular
Dobutamine
Beta-1 Agonist • Inotrope • Acute Heart Failure
DOBUT = do beat + AMINE = of mine
Break dobutamine into DOBUT (sounds like do beat) and AMINE (sounds like of mine). Dobutamine tells the heart to do beat. You know it acts on beta-1, because beat starts with b and it drives one pounding heart, thus beta-1 agonist. It boosts contractility and cardiac output, so the failing heart pumps harder. Beta-1 on, heart beats stronger.
Dobutamine pharmacology mnemonic illustration
Cardiovascular DOBUT = do beat | AMINE = of mine
HOW STEP TESTS IT
1
Dobutamine is a beta-1 agonist. Activating beta-1 receptors on the heart increases contractility (a positive inotrope) and heart rate, which raises cardiac output. It is used for acute decompensated heart failure and cardiogenic shock.
2
Because it drives beta-1, its main risks are increased myocardial oxygen demand, tachycardia, and arrhythmias. It is also used for pharmacologic stress testing to mimic exercise in patients who cannot exercise.
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Practice Question

A 64-year-old man admitted with acute decompensated heart failure is started on an intravenous infusion to raise his cardiac output. Over the next hour his contractility improves, but his heart rate climbs and he develops frequent premature ventricular beats. Which receptor action best explains both the improved pumping and the new arrhythmia?

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