Durgs - Parkinsons - D2 Agonists Flashcards
Which are the D2 receptor agonists used for Parkinson’s?
- Bromocriptine (Parlodel)
- Rotigotine (Neupro)
- Apomorphine (Apokyn)
- Pramipexole (Mirapex) and Ropinirole (Requip)
What is bromocriptine?
And ergot which is a D2 agonist and has very mild D1 antagonism
Does bromocriptine have a longer or shorter half-life and levodopa?
Four times longer
What are the side effects of bromocriptine?
All D2 agonists cause psychiatric disturbances and mental changes such as hallucinations, depression, and insomnia, which are the most frequent calls for discontinuation of the drug. They also cause significant orthostatic hypotension.
What is rotigotine?
It is primarily a D2 agonist but it also stimulates the D1 and D3 receptors
What is the formulation of rotigotine?
It was the first Parkinson’s agent to be administered as a transdermal patch
Which are the two Parkinson’s agents that can cause anaphylactic reactions because they contain sodium metabisulfite?
Rotigotine
Apomorpine
What is apomorphine?
A potent D4 agonist with agonism at the D2, D3, D5 receptors. It has weak agonist or partial agonist at the D1 receptors.
What is apomorphine used for in Parkinson’s?
Freezing episodes in advanced Parkinson’s
What should apomorphine be taken with?
An anti-cholinergic or antihistamine type of antiemetic because it may cause nausea and vomiting. Do not use it with antiemetics that are 5HT3 antagonists because of severe hypotension
What are Pramipexole and Ropinirole?
Non-ergot D2 and D3 agonists
What are the advantages of Pramipexole and Ropinirole over bromocriptine?
Lower incidence of orthostatic hypotension and side effects
What are some side effects of Pramipexole and Ropinirole?
Fatigue and somnolence which may be severe so patients may get sleep attacks. This is also a problem with levodopa and all dopamine agonists used in Parkinson’s.
What can abrupt withdrawal of levodopa or dopamine agonists produce?
Neuroleptic malignant syndrome
