브로모크립틴

도파민 작용제 / 프로락틴 억제제

브로모크립틴은 반합성 맥각 알칼로이드 유도체로 **도파민 작용제** 및 **프로락틴 억제제**로 작용합니다. - **개**: 임신 중절 또는 상상임신에 사용됩니다(위장관 부작용이 적은 카베르골린이 더 선호됨). - **고양이**: 인슐린 요구량을 줄이기 위해 말단비대증의 보조 치료제로 간혹 사용됩니다. - **말**: 역사적으로 뇌하수체 중엽 기능 장애(PPID/말 쿠싱 증후군) 또는 뇌하수체 선종에 사용되었으나, 현재는 페르골리드가 표준 치료제입니다. > **임상 요점**: 브로모크립틴은 개에서 심각한 구토를 유발하는 것으로 악명이 높으며, 이로 인해 임상적 유용성이 제한됩니다. 음식과 함께 투여하거나 항구토제 사용이 필요할 수 있습니다.

작용 기전: Bromocriptine acts primarily by stimulating **postsynaptic dopamine (D2) receptors** in the hypothalamus and anterior pituitary gland. - **Prolactin Inhibition**: Dopamine receptor stimulation → release of prolactin-inhibitory factor (PIF) → direct inhibition of prolactin secretion from the anterior pituitary. - **Acromegaly**: In certain pituitary adenomas, paradoxical suppression of growth hormone (GH) secretion occurs via dopaminergic stimulation. - **CNS Effects**: Activates dopaminergic receptors in the neostriatum of the brain, which can influence motor control and behavior.

동물 종별 용량

Cats

Adjunctive treatment of acromegaly · Initial dose of 0.2 mg (total dose) · Unspecified · Unspecified · May reduce insulin requirements.

Horses

Treatment of pituitary adenoma · 0.03-0.09 mg/kg (30-90 micrograms/kg) twice daily PO or SC · PO/SC · twice daily · Its use is limited. Note: ARCI UCGFS Class 2 Drug.
Treatment of pituitary adenoma · 5 mg (total dose) IM q12h · IM · q12h · To prepare an injectable formulation for IM use from oral dosage forms: Bromocriptine mesylate 70 mg is added to 7 mL of a solution of 80% normal saline and 20% absolute alcohol (v/v). Final concentration is 1% (10 mg/mL).

Dogs

Treatment of pseudocyesis (pseudopregnancy) · 10-100 micrograms/kg PO daily in divided doses until lactation ceases · PO · daily in divided doses · until lactation ceases · Vomiting, depression and anorexia are common side effects, usually more problematic than the lactation.
Treatment of pseudocyesis (pseudopregnancy) · 10-100 micrograms/kg PO twice daily for 10-14 days · PO · twice daily · 10-14 days · Vomiting is very common; reducing dose and administering after meals may help.
Treatment of pseudocyesis (pseudopregnancy) · 10-50 micrograms/kg PO at least twice a day · PO · at least twice a day
Pregnancy termination after mismating · 50-100 micrograms/kg PO or IM twice daily for 4-7 days · PO/IM · twice daily · 4-7 days · From day 35-45 after LH surge. Not uniformly effective and may cause vomiting at this dosage (a peripheral acting antiemetic 30 minutes before dose may be helpful).

투여 경로

POIMSC

금기

Hypertension
Pregnancy (in humans, documented teratogenicity not established but contraindicated)
Nursing/lactating animals (interferes with lactation)

이상반응

Nausea
Vomiting (highly prevalent in dogs)
Sedation
Fatigue
Hypotension
Anorexia
Depression
Trembling
Diarrhea
Tachycardia

약물 상호작용

Alcohol · May cause a disulfiram-type reaction
Butyrophenones (e.g., haloperidol, azaperone) · May increase prolactin concentrations; bromocriptine doses may need to be increased
Amitriptyline · May increase prolactin concentrations; bromocriptine doses may need to be increased
Phenothiazines · May increase prolactin concentrations; bromocriptine doses may need to be increased
Reserpine · May increase prolactin concentrations; bromocriptine doses may need to be increased
Cyclosporine · May elevate cyclosporine levels
Erythromycin · May increase bromocriptine levels
Clarithromycin · May increase bromocriptine levels
Estrogens or Progestins · May interfere with the effects of bromocriptine
Ergot Alkaloids · Not recommended; concurrent use has caused severe hypertension and myocardial infarction in humans
Hypotensive Medications · May cause additive hypotension
MAO Inhibitors (including amitraz, selegiline) · Avoid use of bromocriptine with these compounds
Metoclopramide · May cause prolactin release in dogs, negating the effects of bromocriptine for treating pseudopregnancy

모니터링

Clinical efficacy (dependent upon the reason for use)
Blood pressure (especially if patients exhibit clinical signs associated with hypotension)

과용량

Overdosage may cause **vomiting, severe nausea, and profound hypotension**. - **Clinical Signs in Dogs**: Common findings recorded in decreasing frequency include vomiting, trembling, diarrhea, subdued behavior, and tachycardia. - **Treatment**: Standardized gut removal techniques should be employed when applicable, though emesis often occurs spontaneously. Institute cardiovascular monitoring (blood pressure, heart rate) and provide supportive care as needed.

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