Dopexamine

Dose range is 0 25-6 micrograms kg-1 per minute. Dopexamine is a synthetic analogue of dopamine without a effects. It is a P2 agonist with one-third of the potency of dopamine on DA1 receptors. Dopexamine causes an increase in heart rate and cardiac output as well as causing peripheral vasodilatation and an increase in renal and splanchnic blood flow. Cardiac output is increased as a result of afterload reduction and mild inotropy. In comparison to other inotropes, dopexamine causes less increase in myocardial oxygen consumption. Dopexamine may have some anti-inflammatory activity, but its main focus of interest has been on its ability, at doses of 0-35-0-5 micrograms kg-1 per minute, to improve renal, mesenteric, splanchnic, and hepatic blood flow, which is thought to be beneficial in preserving gastrointestinal mucosal integrity in certain patients. Dopexamine has been shown to improve outcome in certain high risk surgical patients (see Chapter 10). Like dopamine, there is no evidence to justify using dopexamine as a specific treatment for renal failure. The indications for and disadvantages of dopexamine are given in Box 6.5.

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