apomorphine

Class

  • Dopamine agonist, non-ergot
Apomorphine

Commonly Prescribed for

(FDA approved in bold)

  • Parkinson’s disease (PD): acute intermittent treatment of “off” episodes
Apomorphine

How the Drug Works

  • Dopamine agonist, with high affinity for the D2 receptor. This action is likely the main reason for effectiveness in PD
Apomorphine

How Long Until It Works

  • PD – 10–60 minutes
Apomorphine

If It Works

  • PD – this is an adjunctive medication designed for use with other PD treatments. Continue to adjust other PD treatments to achieve maximum functionality
Apomorphine

If It Doesn’t Work

  • PD – adjust PD medication regimen, determine compliance with medications and reconsider the diagnosis
Apomorphine

Best Augmenting Combos for Partial Response or Treatment-Resistance

  • Patients requiring frequent injections will need an improved treatment plan to avoid severe “off” periods. Strategies include shortening the interval of levodopa dosing, adding COMT inhibitors, or adding longer-acting dopamine agonists
Apomorphine

Tests

  • None required

Adverse Effects (AEs)

Apomorphine

How Drug Causes AEs

  • Direct effect on dopamine receptors
Apomorphine

Notable AEs

  • Injection site reactions, drowsiness, nausea or vomiting, dizziness, postural hypotension, hallucinations, edema. Less common hypersexuality or erections
Apomorphine

Life-Threatening or Dangerous AEs

  • May cause somnolence or sudden onset sleep. Severe orthostatic hypotension and nausea/vomiting, even when compared to other PD treatments
Apomorphine

Weight Gain

  • Unusual
Apomorphine

Sedation

  • Common
Apomorphine

What to Do About AEs

  • Orthostatic hypotension: the first dose should be given in a monitored setting (such as a physician’s office). Check supine and standing blood pressure predose and 20, 40, and 60 minutes after injection. If there is no clinical improvement and no AEs, a dose of 4 mg can be given, no earlier than 2 hours after the initial dose
Feb 16, 2017 | Posted by in PHARMACY | Comments Off on apomorphine

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