Cardiovascular Effects

The cardiovascular effects of racemic dobutamine are a composite of the pharmacological properties of the (—) and (+) stereoisomers. Dobutamine has relatively more prominent inotropic than chronotropic effects, compared to isoproterenol. This useful selectivity may arise because peripheral resistance is relatively unchanged due to a counterbalancing of a1 receptor—mediated vasoconstriction and b2 receptor—mediated vasodilation. Alternatively, cardiac a1 receptors may contribute to the inotropic effect. At equivalent inotropic doses, dobutamine enhances automatic-ity of the sinus node to a lesser extent than does isoproterenol; however, enhancement of AV and intraventricular conduction is similar for both drugs.

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