Certified Registered Nurse Infusion (CRNI) Practice Exam

Why should Dobutamine be discontinued slowly?

1. To avoid heart attack risk

2. To prevent chest pain and headache

3. To maintain stable blood pressure

4. To reduce risk of rebound effects

The correct answer is: To reduce risk of rebound effects

Dobutamine is a medication primarily used for heart failure and cardiogenic shock, as it enhances cardiac output by increasing myocardial contractility. When discontinuing Dobutamine, it is important to do so gradually to reduce the risk of rebound effects. Rebound effects can occur when a drug that has been acting as a stimulant is abruptly stopped, leading to an exaggerated response in the body. In the case of Dobutamine, stopping the medication suddenly could lead to a rapid decline in cardiac function and hemodynamic instability. This instability can manifest as worsened heart failure symptoms or other cardiovascular issues. By tapering off Dobutamine, the body's physiology can adjust more smoothly without causing a shock to the system, thereby maintaining more stable and safe physiological parameters. While the other options address important aspects of patient care, they do not directly relate to the pharmacodynamics of Dobutamine and the specific requirement for a gradual discontinuation process. Maintaining stable blood pressure is certainly a concern in general, but the direct reason for the slow discontinuation of Dobutamine specifically hinges on mitigating rebound effects associated with the sudden withdrawal of the med's effects on cardiac output.