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Bromocriptine, originally marketed as Parlodel and subsequently under many brand names, [1] is an ergoline derivative and dopamine agonist that is used in the treatment of pituitary tumors, Parkinson's disease, hyperprolactinaemia, neuroleptic malignant syndrome, and, as an adjunct, type 2 diabetes.
Bromocriptine is a D 2 receptor agonist and D 1 receptor antagonist with a binding affinity to D 2 receptors of anterior pituitary cells, exclusively on lactotrophs. Bromocriptine stimulates Na +, K +-ATPase activity and/or cytosolic Ca 2+ elevation and therefore reduction of prolactin which leads to no production of cAMP.
Dosages of 50 mg to 75 mg daily are usually satisfactory as maintenance therapy for elderly patients who do not tolerate higher amounts. [ 21 ] [ 22 ] In any case, 225 m.g./d. is the absolute-maximum highest recommended dose for this drug, as any more can predispose more significantly to seizures. 150 m.g. is the average optimal daily dose for ...
Prolactin inhibitors are mainly used to treat hyperprolactinemia (high prolactin levels). [1] Agonists of the dopamine D 2 receptor such as bromocriptine and cabergoline are able to strongly suppress pituitary prolactin secretion and thereby decrease circulating prolactin levels, and so are most commonly used as prolactin inhibitors. [1]
Dopamine receptor flow chart. Dopamine receptors are all G protein–coupled receptors, and are divided into two classes based on which G-protein they are coupled to. [1] The D 1-like class of dopamine receptors is coupled to Gα s/olf and stimulates adenylate cyclase production, whereas the D 2-like class is coupled to Gα i/o and thus inhibits adenylate cyclase production.
Cabergoline is frequently used as a first-line agent in the management of prolactinomas due to its higher affinity for D 2 receptor sites, less severe side effects, and more convenient dosing schedule than the older bromocriptine, though in pregnancy bromocriptine is often still chosen since there is less data on safety in pregnancy for ...
Bromopride is indicated in the treatment of nausea and vomiting, including postoperative nausea and vomiting (PONV); gastroesophageal reflux disease (GERD/GORD); and as preparation for endoscopy and radiographic studies of the gastrointestinal tract.
Effects of anticholinergic drugs include: Delirium (often with hallucinations and delusions indistinguishable from reality); Ocular symptoms (from eye drops): mydriasis, pupil dilation, and acute angle-closure glaucoma in those with shallow anterior chamber [11] [12] [13]