溴隱亭
溴隱亭是一種半合成的麥角生物鹼衍生物，作為**多巴胺促效劑**和**催乳素抑制劑**。 - **犬**：用於終止妊娠或假孕（儘管卡麥角林因胃腸道副作用較少而更常被首選）。 - **貓**：偶爾作為肢端肥大症的輔助治療，以減少胰島素需求。 - **馬**：歷史上用於腦下垂體中葉功能障礙（PPID/馬庫興氏症）或腦下垂體腺瘤，儘管培高利特（pergolide）是目前的標準治療。 > **臨床要點**：溴隱亭在犬隻中極易引起嘔吐，這嚴重限制了其臨床實用性。可能需要與食物同服或使用止吐藥。
作用機制: 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.
各物種劑量
- Adjunctive treatment of acromegaly · Initial dose of 0.2 mg (total dose) · Unspecified · Unspecified · May reduce insulin requirements.
- 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).
- 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).
- Abortifacient 25 days after LH surge · Cloprostenol at 1 microgram/kg SC q48 hours (every other day) plus bromocriptine at 30 micrograms/kg PO q24h (every day) · PO/SC · q24h (bromocriptine) · Combination therapy.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新藥品仿單及個別病患確認。
給藥途徑
禁忌症
- Hypertension
- Pregnancy (in humans, documented teratogenicity not established but contraindicated)
- Nursing/lactating animals (interferes with lactation)
不良反應
- Nausea
- Vomiting (highly prevalent in dogs)
- Sedation
- Fatigue
- Hypotension
- Anorexia
- Depression
- Trembling
- Diarrhea
- Tachycardia
藥物相互作用
- 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
監測
- Clinical efficacy (dependent upon the reason for use)
- Blood pressure (especially if patients exhibit clinical signs associated with hypotension)
過量
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.
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠方最新藥品說明書。