dopamine receptor agonists (dopamine responsive conditions)

Question 1

uses of bromocriptine (3)

Answer 1

galactorrhoea
treatment of prolactinomas (when it reduces both plasma prolactin concentration and tumour size)
sometimes in acromegaly

Question 2

bromocriptine inhibits release of GH so is sometimes used in treatment of acromegaly but the following are more effective

Answer 2

but somatostatin analogues (such as octreotide) are more effective.

Question 3

patients intolerant of bromocriptine may be able to tolerate the following drug, even though it has similar SE

and vice versa

Answer 3

cabergoline

Question 4

what is quinaglotide

Answer 4

non-ergot dopamine D2 agonist.

Question 5

which non ergot D2 agonist has actions and uses similar to ergot derives DRA but its SE differ slightly

Answer 5

quinaglotide

Question 6

is quinaglotide an ergot derives DRA

Answer 6

NO it is NON ergot derived

Question 7

what is quinaglotide used for

Answer 7

Hyperprolactinaemia

In hyperprolactinaemic patients, the source of the hyperprolactinaemia should be established (i.e. exclude pituitary tumour before treatment).

Question 8

these two drugs are licensed to suppress lactation but not recommended for routine suppression, or for the relief of symptoms of PP pain and engorrgement that can be adequately treated with simple analgesics and breast support

Answer 8

bromocriptine and cabergoline

Question 9

Although bromocriptine and cabergoline are licensed to suppress lactation, they are not recommended for routine suppression (or for the relief of symptoms of postpartum pain and engorgement) that can be adequately treated with simple analgesics and breast support. If a dopamine-receptor agonist is required, which one is preferred

Answer 9

cabergoline

Question 10

this drug is not licensed for suppression of lactation

Answer 10

quinaglotide

Question 11

important safety info for bromocriptine, cabergoline, quinaglotide

Answer 11

Impulse control disorders

Treatment with dopamine-receptor agonists is associated with impulse control disorders, including pathological gambling, binge eating, and hypersexuality. Patients and their carers should be informed about the risk of impulse control disorders.

Sudden onset sleep

Hypotensive reactions

Question 12

quinaglotide monitoring

Answer 12

BP a few days after starting treatment and following dose increase