FENOLDOPAM - A REVIEW OF ITS PHARMACODYNAMIC AND PHARMACOKINETIC PROPERTIES AND INTRAVENOUS CLINICAL POTENTIAL IN THE MANAGEMENT OF HYPERTENSIVE URGENCIES AND EMERGENCIES

Fenoldopam is a dopamine agonist that causes peripheral vasodilation v ia stimulation of dopamine(1) (D-1) receptors. The efficacy of an intr avenous infusion of fenoldopam in decreasing blood pressure in patient s with a hypertensive urgency including patients who developed hyperte nsion after coronary artery bypass graft surgery and in a small number of patients with hypertensive emergency, is similar to that of sodium nitroprusside. However unlike sodium nitroprusside, fenoldopam also i ncreases renal blood flow and causes diuresis and natriuresis. There i s no evidence of rebound hypertension after stopping the infusion. As the tolerability profile of fenoldopam is generally similar To that of sodium nitroprusside, fenoldopam appears to be an effective alternati ve to sodium nitroprusside in the immediate treatment of patients who develop severe hypertension and in whom oral treatment is not practica l. Fenoldopam may be particularly useful in patients who develop hyper tension after coronary artery bypass graft surgery, but further studie s are required to confirm its role in hypertensive emergency.