Bromocriptine (Ergot Dopamine Agonists)

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Summary

Bromocriptine is a drug used to treat Parkinson’s Disease. There are other drugs in the same class as bromocriptine, such as cabergoline and pergolide, but these are less commonly tested.  Bromocriptine works by activating D2 dopamine receptors.  This activation of dopamine receptors is useful in the treatment of Parkinson’s disease, hyperprolactinemia, as well as neuroleptic malignant syndrome. Bromocriptine has a few nonspecific side effects including headaches, nausea, fatigue, and constipation. A rare side effect of bromocriptine is Raynaud’s phenomenon.

Key Points

  • Bromocriptine, cabergoline, pergolide
    • MOA
      • Ergot dopamine agonist
        • Acts selectively on D2 receptors to mimic endogenous dopamine activity
    • Clinical use
      • Parkinson disease
        • Parkinsonism is due to loss of dopaminergic neurons and excess cholinergic activity
        • Delay need for levodopa in Parkinson’s
      • Hyperprolactinemia (used as 1st line agent)
        • Dopamine tonically inhibits prolactin secretion at anterior pituitary gland in non-pregnant and non-lactating patients
      • Neuroleptic Malignant Syndrome
        • Dopamine agonist activity overcomes neuroleptic-induced dopaminergic blockade
    • Adverse effects
      • Anticholinergic effects
      • Raynaud Phenomenon