Selective and nonselective dopamine receptor agonists: an innovative approach to cardiovascular disease treatment

Dopamine and a new group of selective and nonselective peripheral dopaminergic receptor effectors are being evaluated for the treatment of various cardiovascular disorders, including shock, CHF, and systemic hypertension. Dopamine, in relatively low intravenous doses, will stimulate both peripheral DA1 receptors, which mediate arterial vasodilation of different vascular beds, and the DA2 receptors, which mediate the inhibition of norepinephrine release. Ibopamine is a new oral, nonspecific peripheral dopaminergic agonist with an active metabolite (epinine) that is being evaluated in patients with CHF. Fenoldopam is a selective peripheral DA1 agonist now being developed as a parenteral treatment for hypertensive emergencies. Dopexamine is a parenteral agent that selectively activates both DA1 and beta 2 adrenergic receptors and is being evaluated in patients with CHF and in individuals with postoperative left ventricular dysfunction. A group of selective DA2 receptor agonists is being evaluated as long-term treatment for systemic hypertension.