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[58] [59] If the prolactinoma does not initially respond to dopamine agonist therapy, such that prolactin levels are still high or the tumor is not shrinking as expected, the dose of the dopamine agonist can be increased in a stepwise fashion to the maximum tolerated dose. [3] Another option is to consider switching between dopamine agonists.
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.
A prolactinoma is a tumor of the pituitary gland that produces the hormone prolactin. It is the most common type of functioning pituitary tumor . [ 1 ] Symptoms of prolactinoma are due to abnormally high levels of prolactin in the blood ( hyperprolactinemia ), or due to pressure of the tumor on surrounding brain tissue and/or the optic nerves .
Absorption of bromocriptine oral dose is approximately 28%; however, only 6% reaches the systemic circulation unchanged, due to a substantial first-pass effect. Bromocriptine reaches mean peak plasma levels after about 1–1.5 hours after a single oral dose. The drug has high protein binding, ranging from 90-96% bound to serum albumin.
Prolactin and its receptor are expressed in the skin, specifically in the hair follicles, where they regulate hair growth and moulting in an autocrine fashion. [ 29 ] [ 30 ] Elevated levels of prolactin can inhibit hair growth, [ 31 ] and knock-out mutations in the prolactin gene cause increased hair length in cattle [ 32 ] and mice. [ 30 ]
Dr. Sue Decotiis, a weight loss expert who has prescribed Ozempic to thousands of patients, reportedly explained that weight loss looks more dramatic on those with longer faces because of the way ...
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]
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