Dopaminergic Transmission

Question 1

Dopamine indications

Answer 1

Cardiogenic shock, mild heart failure

Question 2

BROMOCRIPTINE indications

Answer 2

Hyperprolaktinoma, prolaktin cell adenoma

Question 3

Cabergoline

Answer 3

Inhibits lactation

Question 4

Long term bromocriptine side effect

Answer 4

Severe fibrotic reactions+ valve defects

Question 5

Domperidone

Answer 5

D2 blocker
Against neusea, vomiting, delayed gastric emptying

Question 6

Metaclopramide

Answer 6

D2 receptor blocker

Question 7

Side effects of d2 Blockers

Answer 7

Extrapyramidal symptoms

Question 8

Haloperidol

Answer 8

i. Haloperidol is a typical antipsychotic and acts as a D2R antagonist; will reduce positive symptoms of psychosis disorder, risk of QT prolongation and extrapyramidal side effects

Question 9

Haloperidol + l-dopa

Answer 9

iii. Haloperidol will neutralize L-DOPA activity, as L-DOPA will increase dopamine levels, but haloperidol will prevent that increase from having any worthwhile effects.

Question 10

Haloperidol + spironolactone

Answer 10

i. Haloperidol = antipsychotic D2R antagonist, improves positive symptoms of psychological disorders, extrapyramidal symptoms, dyskinesia, prolactinemia; Side effects = dizziness, drowsiness, sleep disturbances, headache, anxiety, parkinsonism or neuroleptic malignant disorder, orthostatic hypotension
ii. Spironolactone = potassium sparing diuretic that is an aldosterone antagonist and will decrease sodium reabsorption, leading to upregulated sodium and fluid excretion; AEs = hyperkalemia, GI effects, headache, dizziness, drowsiness
iii. Both can induce orthostatic hypotension as a side effect of their respective MOAs, so combined they potentiate this risk

Question 11

Haloperidol+ ropirinol

Answer 11

Opposite effects, ropirinol is used in alzeihmers treatment and is a d2 agonist whereas haloperidol is a d2 anatagonist