Adverse effects associated with the newer inotropic agents.

The ideal inotropic agent should be available for both parenteral and oral administration and be potent and effective long term without significant adverse effects. In recent years, numerous new agents have been developed in an attempt to find a more potent, less toxic alternative to digoxin. beta-Agonists, while useful when given parenterally short term, appear to have their long term oral application limited by adverse effects and the development of tolerance. A number of other non-catecholamine agents, most of which have both inotropic and vasodilator actions, have also been studied. Adverse effects have been relatively frequent and occasionally severe. Of these newer agents none has yet been proven in clinical trials to be safe and effective in the long term.