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apomorphine (Apokyn, Uprima)
Tradenames: Uprima, Apokyn
Indications:
1) treatment of Parkinson's disease (FDA approved 2004)
- treatment of acute hypomobility episode of advanced Parkinson's Disease [3]
2) treatment of parkinsonism
3) erectile dysfunction
Dosage:
1) 2-3 mg sublingually (Uprima) 15-30 minutes prior to intercourse*
2) injectable (Apokyn) with an antiemetic
- trimethobenzamide (Tigan) 300 mg PO TID [2]
- start 3 days prior to apomorphine
- continue for at least 1st 2 months of apomorphine treatment
* discontinued by manufacturer because of high incidence of adverse effects (nausea/vomiting, hypotension, sedation)
Pharmacokinetics:
-> metabolized by COMT
Adverse effects:
1) nausea/vomiting#
2) dizziness
3) headache
4) bradycardia
5) hypotension
6) fainting
7) sedation
# most patients will need an antiemetic
Drug interactions:
1) dopamine receptor antagonists
2) 5HT3 antagonists (ondansetron)
Mechanism of action:
1) dopamine receptor agonist
2) centrally-acting agent
Interactions
drug adverse effects (more general classes)
General
aporphine
dopaminergic receptor agonist
emetic
Properties
AGONIST-FOR: adrenergic receptor
Database Correlations
PUBCHEM correlations
References
- Prescriber's Letter 7(5):28, May 2000
http://www.fda.gov/bbs/topics/answers/2004/ANS01284.htm
- Prescriber's Letter 11(6):33 2004
Detail-Document#: 200608
(subscription needed) http://www.prescribersletter.com
- Department of Veterans Affairs, VA National Formulary
- restricted to neurology for treatment of acute hypomobility
episode of advanced Parkinson's Disease.