Dopaminergic effects on kidney function and responsiveness of aldosterone, plasma renin activity, prolactin, catecholamines, and blood pressure to stimulation in patients with prolactinoma. Comparison of the efficacy of pergolide and bromocriptine therapy.
8 beta-[(Methylthio)methyl]-6-propylergoline (pergolide) is a new, potent, long-acting dopaminergic DA2 receptor agonist currently being investigated for therapeutic use in patients with hyperprolactinemia, acromegaly or Parkinsons's disease. Since the influence of bromocriptine, a well-established dopaminomimetic compound, on aldosterone responsiveness and plasma renin activity is still a matter of debate, the efficacies of both compounds on these parameters and on kidney function, blood pressure, catecholamine release and prolactin levels were compared in 16 patients with prolactinoma. Supine and furosemide (40 mg i.v.)-stimulated plasma renin activity and aldosterone levels were similarly decreased by bromocriptine (2.5-30 mg/d) and pergolide (50-500 micrograms/d). Suppression of blood pressure, inhibition of stimulated norepinephrine release, increase in creatinine clearance, and decrease in base-line prolactin levels were similarly pronounced during treatment with both compounds. Metoclopramide (10 mg i.v.)-induced stimulation of aldosterone and prolactin levels, however, were suppressed only by bromocriptine and not by pergolide. It remains to be studied whether this difference between bromocriptine and pergolide is due to a potential agonist effect of pergolide on dopaminergic DA1 receptors which are influenced by bromocriptine in an antagonistic manner, or whether pergolide can be more readily displaced from its receptors than bromocriptine.
Jungmann
E
E
Abteilung für Endokrinologie, Johann Wolfgang Goethe-Universität, Frankfurt/Main, Fed. Rep. of Germany.
Haak
T
T
Althoff
P H
PH
Fassbinder
W
W
Schöffling
K
K
D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects*; D001971:Bromocriptine / Q000494:pharmacology; D002395:Catecholamines / Q000097:blood; D004298:Dopamine / Q000502:physiology*; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D010479:Pergolide / Q000494:pharmacology; D010911:Pituitary Neoplasms / Q000188:drug therapy / Q000378:metabolism*; D011388:Prolactin / Q000097:blood / Q000378:metabolism*; D012083:Renin / Q000097:blood; D013268:Stimulation, Chemical
D002395:Catecholamines; D010479:Pergolide; D001971:Bromocriptine; D000450:Aldosterone; D011388:Prolactin; D012083:Renin; D004298:Dopamine; D009638:Norepinephrine