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[New dopamine agonists in cardiovascular therapy].
A R Girbes1, D J Van Veldhuisen, A J Smit
1Service de Chirurgie, Soins intensifs, Academisch Ziekenhuis Groningen, Pays-Bas.
Presse Medicale (Paris, France : 1983)
|August 5, 1992
Summary
Dopamine and its agonists like fenoldopam, dopexamine, and ibopamine are used in intensive care. New oral dopamine agonists offer potential advantages for treating heart failure and improving renal function.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
- Nephrology
Context:
- Dopamine is a catecholamine widely used in intensive care, acting on various adrenergic and dopaminergic receptors.
- Its renal effects, including vasodilation and natriuresis, are mediated by dopamine-1 receptor (DA1) stimulation.
- DA2-receptor stimulation influences aldosterone and norepinephrine levels.
Purpose:
- To review the pharmacological actions of dopamine and newer dopamine agonists.
- To discuss their applications in intensive care, particularly for congestive heart failure and renal function.
- To highlight the development of selective agonists like fenoldopam and orally available ibopamine.
Summary:
- Fenoldopam, a selective DA1-agonist, causes renal and systemic vasodilation, increasing renal blood flow, natriuresis, and diuresis.
- Dopexamine, a DA1- and beta-2 agonist, is used intravenously for congestive heart failure, similar to dopamine.
- Ibopamine is an orally active selective dopamine agonist demonstrating efficacy in congestive heart failure with mild renal effects.
Impact:
- Newer dopamine agonists offer targeted therapeutic benefits for cardiovascular and renal conditions.
- The development of orally available agents like ibopamine expands treatment options for heart failure.
- Understanding receptor selectivity is crucial for optimizing dopamine agonist therapy in critical care settings.