Dopamine Receptor Agonists

Question 1

Given with earlier or later presentation?

Answer 1

Earlier.

If later, do levadopa right from the start

Question 2

Bromocriptine

Answer 2

D2 agonist

Half life 15 hrs, peak plasma conc 1-3 hrs

Extensive first-pass metabolism

Question 3

Pramipexole

Answer 3

D3 receptors

Used in RLS too

Half life 8 hrs, peak plasma conc 2 hrs

90% excreted unchanged. Pts w/ renal issues may need dose adjustment

Question 4

Ropinirole

Answer 4

D2 receptors

RLS treatment too

Metabolized by CYP450, (CYP1A2 primarily)

Peak plasma conc 1-2 hrs, 1/2 life 6 hrs

Question 5

Bromocriptine adverse effect

Answer 5

Digital vasospasm during long-term treatment

Question 6

Contraindications for dopamine receptor Agonists

Answer 6

Recent MI, psychotic illness, active peptic ulcer

Bromocriptine- pts w/ PVD