Dopamine pramipexole

The dopamine receptor agonists, such as pramipexole (Mirapex) and ropinirole (Requip), are used for die treatment of die signs and symptoms of Parkinson s disease... 

The phenotiiiazines may decrease the effectiveness of tiie dopamine receptor agonists. When pramipexole is administered concurrently witii cimetidine, ranitidine, verapamil, and quinidine, there is an increased effect of pramipexole When ropinirole is administered with the estrogens, particularly estradiol, there may be an increased effect of ropinirole... 

Opioids, benzodiazepines, barbiturates, corticosteroids, dopamine agonists (e.g., amantadine, bromocriptine, levodopa, pergolide, pramipexole, ropinirole), H2-receptor antagonists, anticholinergics (e.g., diphenhydramine, trihexylphenidyl), P-adrenergic blockers, clonidine, methyldopa, carbamazepine, phenytoin, baclofen, cyclobenzaprine, lithium, antidepressants (e.g., tricyclic antidepressants, selective serotonin reuptake inhibitors), and interleukin-2... 

Maggio R, Scarselli M, Novi F, Millan MJ, Corsini GU. Potent activation of dopamine D3/D2 heterodimers by the antiparkinsonian agents, S32504, pramipexole and ropinirole. J Neurochem 2003 87 631-641. 

Lagos P., Scorza C., Monti J. M. et al. (1998). Effects of the D3 preferring dopamine agonist pramipexole on sleep and waking, locomotor activity and striatal dopamine release in rats. Eur. Neuropsychopharmacol. 8(2), 113-20. 

The most important alternatives to levodopa therapy are direct-acting dopamine receptor agonists, such as ropinirole,pramipexole, or pergolide (Fig. 46-5). A number of studies have shown that use of these agents may help to delay the need for use of levodopa/carbidopa. This has... 

Dopamine-Boosting Medications. Levodopa/carbidopa (Sinemet), bromocriptine (Parlodel), pramipexole (Mirapex), and ropinirole (Requip) increase dopamine nenrotransmission in the brain by one or another mechanism. These medications do not reliably induce sleep, and in some patients are activating. They are certainly not true sedative-hypnotics. They are most often used by neurologists to treat Parkinson s disease. 

Pharmacoiogy ApomorpWine, pramipexole, and ropinirole are non-ergot dopamine agonists for PD with high specificity at the D2 subfamily of dopamine receptors, binding with higher affinity to D3 than to D2 or D4 receptor subtypes. 

Geriatric Considerations - Summary Pramipexole is a nonergot dopamine agonist that directly stimulates dopamine Dj receptors. It can be used in combination wit h le-vodopa or as monotherapy. If discontinued, pramipexole should be slowly tapered because abrupt discontinuation can cause confusion, hallucinations, and a condition similar to neuroleptic malignant syndrome. 

Dopamine agonists bromocriptine mesylate pergolide mesylate pramipexole dihydrochloride ropinirole hydrochloride... 

FIGURE 7—42. Adrenergic combo 3 The actions of bupropion at dopamine neurons can be double-boosted by a direct-acting dopamine D2 and D3 agonist such as pramipexole. Norepinephrine is also single-boosted by bupropion. 

FIGURE 7—48. Heroic combo 4 High-dose venlafaxine plus stimulant. Here, 5HT and NE are single-boosted and DA is double-boosted. The stimulants could include (/-amphetamine, methylphen-idate, phentermine, or diethylpropion. It could also include direct-acting dopamine agonists such as pramipexole. 

Dopamine agonists Bromocriptine Cabergoline Pergolide Pramipexole Ropinirole Directly stimulates dopamine receptors in basal ganglia. May produce fewer side effects (dyskinesias, fluctuations in response) than levodopa preliminary evidence suggests that early use may also delay the progression of Parkinson disease. 

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