Pharmacology: prolactin-related drugs

Question 1

Answer 1

Question 2

HYPERPROLACTINEMIA
3 causes?
2 consequences?

Answer 2

Dopamine antagonists (eg. first generation antipsychotics)
Excessive TRH (eg. hypothyroidism)
Pituitary tumours (too much lactotrophs)

Galactorrhoea (milk production unrelated to pregnancy or lactation)
Infertility

Question 3

HYPERPROLACTINEMIA
Treatment?

Answer 3

Dopamine agonists - to reduce lactation

Question 4

HYPERPROLACTINEMIA
Dopamine agonists
- What are the 2 drugs?
- ADRs?
- Can tolerance develop to these ADRs?

Answer 4

Cabergoline and bromocriptine

Nausea and vomiting (due to stimulation of central chemoreceptors)
Dizziness, postural hypotension (due to peripheral vasodilation of dopamine)

Yes, tolerance can develop

Question 5

HYPOPROLACTINEMIA
Treatment?

Answer 5

Dopamine antagonists - to promote lactation.

Question 6

HYPOPROLACTINEMIA
What are the two dopamine antagonists used to promote lactation?

Do these drugs have only modest effects, and safety concerns?

Answer 6

Domperidone (first line) and metoproclamine

Yes to both