HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE Section: 8-14
Medications: Attachment A- Management of Dobutamine __RN
ATTACHMENT A
MANAGEMENT OF DOBUTAMINE
SIDE EFFECTS & COMPLICATIONS
Patient education and good physician
assessment and evaluation is the foundation for
management of Dobutamine infusion therapy in
the home.
1. Home care nurse is to educate patient or
patient's caregiver on proper care of catheter
exit site and central line to prevent infection.
If an infection does occur, antibiotic is to be
administered without interrupting
Dobutamine infusion. Type of antibiotic is to
be determined by the physician.
2. Arrhythmias resulting from Dobutamine
induced hypokalemia in some patients could
be prevented by oral potassium supplement.
The recommended dose is 40 to 100
meq/day.
3. If irregular heartbeat or palpitation occurs
during Dobutamine infusion, the infusion has
to be stopped and the physician has to be
notified immediately. A non-specific beta
blocker is recommended (i.e., propranolol,
dose at 10 to 20 mg every 6 hours initially).
Individualized dosage is to be determined by
the physician.
4. Dose related increase in patient's heart rate
and blood pressure can be caused by an
increase in Dobutamine infusion rate. MD is
to be notified when HR is 15-20 beats >
baseline or BP is 30 mm Hg > baseline.
Educate patient to monitor flow rate and use
of infusion pump to avoid overdosing and its
complications.
5. If nausea and vomiting occur, physician may
order any of the following medications:
a. Prochlorperazine (Compazine) 0.3-0.6
mg/kg orally.
b. Trimethobenzamide (Tigan) 3.0-4.0
mg/kg orally.
c. Diphenhydramine (Benadryl) 0.3-0.6
mg/kg orally.
6. If headache persists during the Dobutamine
infusion the physician may order aspirin or
Tylenol 15-20 mg/kg orally, the dosage may
be repeated as needed.
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