Dopamine receptor agonists

Question 1

Ergot-derived

Answer 1

Bromocriptine
Cabergoline
Pergolide

Question 2

Non-ergot derived

Answer 2

Pramipexole
Ropinirole
Rotigotine

Question 3

Others

Answer 3

Amantadine (weak dopamine agonist)
Apomorphine (advanced disease for unpredictable “off” periods

Question 4

MoA

Answer 4

Direct action on dopamine D2 receptors in striatum

Question 5

When would they be used?

Answer 5

Non-ergot derived are 1st line in patients whose motor symptoms do not affect QoL
OR as an adjunct to levodopa

Question 6

Associated with?

Answer 6

More hallucinations, excessive sleepiness & impulse control disorders

Question 7

SE of ergot-derived dopamine agonists

Answer 7

Fibrotic reactions
Pulmonary - dyspnoea, persistent cough
Retroperitoneal - abdominal pain + tenderness
Pericardial - cardiac failure

Question 8

Side effects

Answer 8

1. Impulse control disorders
2. Excessive sleepiness/sudden onset of sleep
3. Psychotic symptoms (hallucinations, delusions)
4. Hypotensive reaction in first few days (warning: driving/operating heavy machinery)