Dopamine Agonist

Aka: Dopamine Agonist, Non-ergot Dopamine Agonist, Ergot Dopamine Agonist

advertisement

II. Preparations: Non-ergot Dopamine Agonists (as dosed in Parkinson's Disease)

  1. General: Parkinson's Disease related concerns
    1. Less effective than Levodopa, but are less associated with Dyskinesias
    2. Most effective agents at reducing Levodopa off-time
    3. Increased Sleepiness, edema, Nausea and Hallucinations
  2. Dosing
    1. Start at low dose and may titrate to symptom control every 5-7 days
    2. When stopping agents, taper off over 2-3 weeks
  3. Pramipexole (Mirapex)
    1. Immediate Release start 0.125 mg three times daily (may increase by 0.125-0.25 mg/week up to 4.5 mg/day)
    2. Extended Release start 0.375 mg daily (may increase by 0.75 mg/week up to 4.5 mg/day)
    3. Half life: 7-17 hours
    4. Minimal metabolism
  4. Ropinirole (Requip)
    1. Immediate Release start 0.25 mg three times daily (may increase by 0.25 mg/week up to 24 mg/day)
    2. Extended Release start 2 mg daily (may increase by 2 mg/week up to 24 mg/day)
    3. Half life: 6 hours
    4. Hepatic metabolism
  5. Rotigotine (Neupro) transdermal patch
    1. Apply once daily (available in 1, 2, 3, 4, 6 and 8 mg)
    2. One patch applied daily to a new site
    3. Do not repeat the same site for 14 days
    4. Start at 2 mg/24 hours
    5. May increase weekly to a maximum of 8 mg/24 h
  6. Apomorphine
    1. Dopamine Agonist prn for off-time and severe motor freezing episodes
    2. Start at low dose with first dose in neurology office with Blood Pressure and pulse monitoring
    3. Give with Antiemetic (NOT Zofran due to interaction causing Hypotension, Syncope)
    4. Titrate to effective dose every few days
    5. Preparations
      1. Apomorphine SQ Injection (Apokyn) (30 mg/3 ml) pen in marked in ml (not mg)
      2. Apomorphine Sublingual Film (Kynmobi)

III. Preparations: Ergot Dopamine Agonists (as dosed in Parkinson's Disease)

  1. Avoid these agents in Parkinson's Disease Management
  2. Diagnostics required when on Ergot Dopamine Agonists (baseline and annual)
    1. Echocardiogram
    2. Chest XRay
    3. Erythrocyte Sedimentation Rate (ESR)
    4. Renal Function tests
  3. Bromocriptine Mesylate (Parlodel)
    1. Start at 1.25 mg PO bid
    2. Increase every 2 weeks to 5-20 mg PO bid
    3. Half life: 3-8 hours
    4. Hepatic metabolism
  4. Pergolide Mesylate (Permax): Not recommended (not available in U.S.)
    1. Half life: 27 hours
    2. Hepatic metabolism
    3. Risk of valvular disease and Pulmonary Hypertension
      1. Van Camp (2004) Lancet 363:1179-83 [PubMed]

IV. Adverse Effects

  1. Somnolence
    1. Risk of sudden onset of sleep without warning ("Sleep Attacks")
  2. Hallucations
  3. Impulse control behaviors (uncommon)
    1. Behaviors seen with Dopamine Agonists include Compulsive Gambling, hypersexuality, shopping, eating
    2. Moore (2014) JAMA Intern Med 174(12):1930-3 [PubMed]

V. References

  1. Ahlskog (2011) Mayo Internal Medicine Review Lecture
  2. Schim (2001) CMEA Medicine Lecture, San Diego
  3. Clarke (2003) Clin Evid 10:1582-98 [PubMed]
  4. Clarke (2004) Lancet Neurol 3:466-74 [PubMed]
  5. Gazewood (2013) Am Fam Physician 87(4): 267-73 [PubMed]
  6. Nutt (2005) N Engl J Med 353:1021-7 [PubMed]
  7. Olanow (2001) Neurology 56:S1-88 [PubMed]
  8. Rao (2006) Am Fam Physician 74:2046-56 [PubMed]
  9. Young (1999) Am Fam Physician 59(8):2155-67 [PubMed]

Images: Related links to external sites (from Bing)

These images are a random sampling from a Bing search on the term "Dopamine Agonist." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images

Related Studies

Ontology: Dopamine Agonists (C0178601)

Definition (NCI) Any agent that binds to and activates dopamine receptors.
Definition (MSH) Drugs that bind to and activate dopamine receptors.
Definition (CSP) class of drugs and natural products which enhance dopaminergic function by increasing dopamine biosynthesis, decreasing dopamine degradation or reuptake, or interacting positively with dopamine receptors.
Concepts Pharmacologic Substance (T121)
MSH D018491
SnomedCT 108808007, 395987003, 384952006, 418222008
English Agonists, Dopamine, Agonists, Dopamine Receptor, Dopamine Receptor Agonists, Receptor Agonists, Dopamine, dopamine agonist, Agonist, Dopamine, Agonist, Dopamine Receptor, Agonist, Dopaminergic, Agonists, Dopaminergic, Dopamine Agonist, Dopamine Receptor Agonist, Dopaminergic Agonist, Dopaminergic Agonists, Receptor Agonist, Dopamine, Dopaminergic drugs used in parkinsonism, Dopaminergics in parkinsons, RECEPT AGON DOPAMINE, DOPAMINE AG, DOPAMINERGIC AG, DOPAMINERGIC AGON, AGON DOPAMINERGIC, DOPAMINE RECEPT AG, AGON DOPAMINE RECEPT, DOPAMINE AGON, DOPAMINE RECEPT AGON, Dopaminergics, dopamine receptor agonist, dopamine agonists (medication), dopamine agonists, Dopamine Agonists, dopaminergic agonists, agonist dopamine receptor, agonists dopamine receptor, Dopamine agonists, Dopamine agonist (product), Dopamine agonist, Dopamine receptor agonist (substance), Dopamine receptor agonist, Dopamine--Agonists, Dopamine agonist product (product), Dopamine agonist product, Dopamine agonist (substance), Dopamine agonist agent (substance), Dopamine agonist agent
Spanish agonista de dopamina, agonista dopamínico (sustancia), agonista dopamínico, agonista dopaminérgico (producto), agonista dopaminérgico, agonista del receptor de dopamina (sustancia), agonista del receptor de dopamina, agonista de la dopamina (producto), agonista de la dopamina, agonista dopaminérgico (sustancia), Agonistas de Dopamina, Agonistas de Receptores de Dopamina, Agonistas Dopaminérgicos
French Agonistes de la dopamine, Agonistes du récepteur de la dopamine, Agonistes des récepteurs dopaminergiques, Agonistes dopaminergiques
Swedish Dopaminstimulerare
Czech dopamin agonisté
Finnish Dopamiiniagonistit
Italian Agonista del recettore della dopamina, Agonista della dopamina, Agonisti del recettore della dopamina, Agonista dopaminergico, Agonisti dopaminergici, Agonisti della dopamina
Russian DOFAMINA RETSEPTOROV AGONISTY, DOFAMINERGICHESKIE AGONISTY, DOFAMINA AGONISTY, ДОФАМИНА АГОНИСТЫ, ДОФАМИНА РЕЦЕПТОРОВ АГОНИСТЫ, ДОФАМИНЕРГИЧЕСКИЕ АГОНИСТЫ
Croatian DOPAMINSKI AGONISTI
Polish Agoniści dopaminy, Agoniści dopaminergiczni, Agoniści receptora dopaminowego
Japanese ドーパミン作動剤, ドーパミンアゴニスト, ドーパミン作用薬, ドーパミン受容体作用薬, ドーパミン作用剤, ドーパミン受容体作用物質
German Dopaminagonisten, Dopaminerge Agonisten, Dopaminrezeptoragonisten
Portuguese Agonistas de Dopamina, Agonistas Dopaminérgicos, Agonistas dos Receptores de Dopamina
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Ergot-derived Dopamine Receptor Agonist [EPC] (C2917378)

Concepts Pharmacologic Substance (T121)
English Ergot-derived Dopamine Receptor Agonist [EPC], Ergot-derived Dopamine Receptor Agonist
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Nonergot Dopamine Agonist [EPC] (C2917438)

Concepts Pharmacologic Substance (T121)
English Nonergot Dopamine Agonist, Nonergot Dopamine Agonist [EPC]
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Pharmacology

advertisement

2025 Family Practice Notebook, LLC. Terms | Privacy | About | Site Map | Newsletter | Blog

Footer Site Logo