Dopamine agonists heart failure

Dopamine itself has long been used as an inotropic agent in acute treatment of congestive heart failure. Both that compound and a number of its analogues have a positive action on contractility as a consequence of their adrenergic agonist activity. 

Dopamine Dopamine receptor agonist higher doses activate 13 and a adrenoceptors Increases renal blood flow higher doses increase cardiac force and blood pressure Acute decompensated heart failure shock IV only duration a few minutes Toxicity Arrhythmias Interactions Additive with sympathomimetics... 

Dopamine and dobutamine are sometimes used to stimulate the heart in cases of acute or severe heart failure (see Chapter 20). Dopamine and dobutamine exert a fairly specific positive inotropic effect, presumably through their ability to stimulate beta-1 receptors on the myocardium.60 Other beta-1 agonists (epinephrine, prenalterol, etc.) will also increase myocardial contractility, but most of these other beta-1 agonists will also increase heart rate or have other side effects that prevent their use in congestive heart failure. Dopamine and dobutamine are usually reserved for patients with advanced cases of congestive heart failure who do not respond to other positive inotropic drugs (e.g., digitalis).6,72... 

The studies of Goldberg and colleagues have been and remain pioneering in not one but at least two fronts. First, the concepts and demonstration of vascular dopamine receptors has allowed and stimulated detailed studies of the location, function, mechanism, and role of peripheral dopamine and dopamine receptors. Second, their work led to and accelerated the utilization of dopamine agonists in clinical medicine with the use of intravenously administered dopamine for shock and heart failure being the best example. 

Dobutamine is a racemic mixture of d- and 1-dobutamine. The racemate behaves primarily a pj-adrenoceptor agonist with greater inotropic than chronotropic effects on the heart it has some a-agonist effect, but less than dopamine. It is useful in shock (with dopamine) and in low output heart failure (in the absence of severe h5 ertension). 

The under-reporting of the results of clinical trials in patients with heart failure has been reviewed (7). Some trials that have been unpublished or published only in abstract or preliminary form have involved drugs with positive inotropic effects, such as the phosphodiesterase inhibitor vesnarinone (SEDA-23, 195), the beta-adrenoceptor partial agonist xamoterol, and the dopamine receptor agonist ibopamine. 

ADRENOCEPTOR AGONIST Selective for the p2 Subtype, also with activity as a (peripheral D,) DOPAMINE RECEPTOR AGONIST. Therapeutically, it can be used in HEART FAILURE treatment. Dopram doxapram. 

Indications Heart failure associated with cardiac surgery Category Beta2-adreneric agonist Dopamine receptor agonist Half-life 6-1 I minutes... 

The discovery of the selective vasodilation produced by dopamine in the renal circulation and of its natriuretic effects, both mediated by D receptors, respectively in renal arteries and in renal tubules, prompted research of new D selective and peripherally acting agonists, potentially useful in the treatment of congestive heart failure and of hypertension. In the most severe forms of the former clinical condition, dopamine is used by intravenous infiision, taking... 

Peripheral dopaminergic receptor agents are useful in the treatment of congestive heart failure (CHF). Two distinct subtypes of dopamine receptors have been identified. The dopamine (DAi) receptors, which are located on vascular smooth muscles, cause vasodilation in the renal, mesentery, cerebral, and coronary vascular beds (see Figure 49). Thus, the pharmacologic response to activation of the DA2- and DAj-receptor receptors is hypotension, bradycardia, diuresis, and natriuresis. Fenoldopam is an orally active DA -receptor agonist. It is more potent than dopamine in causing... 

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