Dopamine & Dobutamine - with a Mnemonic - Cardiac Pharmacology (6)

[@MedicosisPerfectionalis]

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[@lanaali5730]

hey ! first of all love your content. so umm just a little misunderstanding i hope you get to see it, at the end of the video in your case #2; where the pt has CHF but no hypotention, you previously said that because dobutamine is a B2 agonist it causes vasodilation so as then hypotension, but you eventually said that we will use dobutamine as the answer of case #2 and that it can lead to ((hypertension)). could you please briefly explain that point. thank you for your time c:

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[@nimmir7099]

Could you please explain the 2nd case again where you said dobutamine should be used?:) Was a bit confusing?

[@rayspace6362]

I think he misworded it a bit, Dobutamine may cause Hypotension by vasodilation and in the 2nd case, pat didn't have hypotension, so normotension. Technically both could be used but dobutamine wouldn't be as harmful in pat 2 as in pat 1 who is already hypotensive to begin with, it would probably lead to hypotensive shock. So both could be used in 2nd case, it was just to show case the diff situations and more so in case 1 only Dopamine would be the right option of the two.

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Medicine make perfect sense. Indeed.

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[@mdmainuddinkhan3393]

Excellent presentation...

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[@iAR187]

Wait I didn't get Case 2 and the dobutamine effect there. You said it causes vasodilation which could lead to hypotension, but when you answered the question you said it might raise the blood pressure.

[@nimmir7099]

Yeah the 2nd case I thought both of them can be used?

[@Tonymakaroni12]

at low doses dopamine is a vasodilator, at high doses dopmanin is a vasoconstrictor, so used for low bp

[@maryambaloch9231]

Because 2nd case have no hypotension, therefore why should we give dopamine to increase BP, when there is no need to do with BP.

[@faryalroy1443]

I also have same question. I think its by mistake. But one thing I want to say is that dopamine also causes hypotension. As patients of parkinsons disease those who take medications for dopamine have hypotension. Low dose dopamine case hypotension hight dose dopamine cause increases perfusion

[@riteshchaurasia4953]

9:53 case 2 sir u told dobutamine causes vasodilation so decrease in bpbut again in case 2 it causes increase in bp..how !?

[@sadmanjaoad6994]

In case 2 example, you said dobutamine can raise the BP? I thought it reduces BP. And since BP is normal, and I want to maintain renal perfusion, can I consider dopamine an option in case 2 ? Or should I opt for dobutamin just because a raised BP from dopamine might worsen the HF?

[@lareinadelanoche1]

I am confused over the same thing here

[@Azoozy1993]

Yes you right but he was fast thats is why he make mistake (😅

[@an5780]

It raises BP still because beta 1 outpowers beta 2. So the increased contractility increases the bp. There is slight vasodilation and sometimes rebound hypotension but at the core it raises bp this is highly subjective due to renal dosing vs cardiac level dosing. But overall it increases bp in majority of cases.

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[@RBall-tc7zn]

Hello. There is a lot of confusion about why Dopamine causes vasoconstriction and therefore increases BP (as opposed to dobutamine which lowers BP). I think this is because you didn't highlight a key difference : Dopamine also activates Alpha 1 and 2 receptors = vasoconstriction. Dobutamine does not do this, acting on the beta receptors to cause vasodilation.

[@GodofBoris]

You’re the best man

[@MedicosisPerfectionalis]

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[@opiniontime582]

At around 9 mins you are saying that Dobutamine will not increase BP it will decrease it BUT for case 2 answer you said we should give Dobutamine cuz it can not decrease BP

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There’s a new video about it on my channel...Just uploaded today!

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[@MedicosisPerfectionalis]

I read a lot and take my own notes, and then read more and update the notes. Start by reading smaller books and then read longer ones. The internet is cool, but there’s nothing like a good book that you can hold in your hands and annotate. I don’t give up on any topic no matter how unattainable it seems in the beginning. Good luck 🍀

[@tanyasaxena1580]

Thnku so much 🥺🥺

[@ginamasters4846]

I thought I had it, but now I am confused by a few statements....DOPAmine increases BP. DoBUTAmine does not and causes vasodilation d/t activating B2 (At least that's what you were saying around 8:35 mark). THEN, toward the end, you said that dobutamine might even "RAISE BP." Could you explain how it could do both or was that in error? I would think that something that increases heart contractility but also vasodilates---would lead to increased HR and improve cardiac output, and decrease bp via lower pvr? Or, does it have different effects on different people? Maybe it's super late and I'm overthinking this too much. Thanks in advance for clarification!

[@charliecharlie6547]

Hi,,,, will you plz explain dromotropy,,,, in positive dromotropy heart rate increase or contraction

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Thanks!

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[@Dr.anamitra]

That's nice review. Can you please check at 9:48 ?

[@MedicosisPerfectionalis]

??

[@ThatsWhy-]

Maybe, if you give high Duptamine , you may desensitize Beta-2 thus causing high BP !

[@deborahrippe5641]

Love!!

[@riteshchaurasia4953]

6:38how does digoxin inhibiting na k pump increases contractility since due to inhibition na stays intracellular and due to its its greater intracellular presence how does secondary pump or calcium channel operate..since secondary or calcium channel works on greater conc of extracellular na ion..!?

[@wisammaqbool6789]

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[@Naraxus]

Ehmmm… 1. evidence is absolutely against the use of dopamine to increase renal perfusion (at least in regards of patients outcome). (See guidelines) 2. Dobutamines not-bp-raising is mainly related to alpha-1-antagonism and not beta-2-agonism (see first description from 1975 where bp decreased after phenoxybenzamine but not after propranolol) 3. Dobutamine does actually increase renal perfusion (or at least renal blood flow) too (which is not outcome-relevant in RCTs either). (See Meier-Hellmann 2000) The video is well produced but the information is wrong….

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