scholarly journals Recurrent Priapism From Cabergoline and Bromocriptine in a Hypogonadal Man With Prolactinoma

2021 ◽  
Vol 9 ◽  
pp. 232470962110297
Author(s):  
Lakshmi P. Menon ◽  
Wedad Rahman
Keyword(s):  
Pituitary Adenoma ◽  
Prolactin Level ◽  
Side Effect ◽  
Dopamine Agonists ◽  
First Line ◽  
Potential Side Effect ◽  
First Line Therapy ◽  
Line Therapy ◽  
Rare Side Effect ◽  
Recurrent Priapism

Dopamine agonists are generally well tolerated and represent the first-line therapy for prolactinomas. We report a case of a 20-year-old man with a macroprolactinoma who developed recurrent priapism with cabergoline and bromocriptine. Transsphenoidal pituitary adenoma resection was done with normalization of the prolactin level. Priapism is a rare side effect of dopamine agonists that warrants discontinuation of therapy. Patients should be educated about this potential side effect at the time of prescribing the medication.

scholarly journals Quinagolide – a valuable treatment option for hyperprolactinaemia

2006 ◽  
Vol 154 (2) ◽  
pp. 187-195 ◽  
Author(s):  
Anne Barlier ◽  
Philippe Jaquet
Keyword(s):  
Dopamine Agonists ◽  
Pharmacological Intervention ◽  
Plasma Prolactin ◽  
Dosing Regimen ◽  
First Line ◽  
First Line Therapy ◽  
Gonadal Dysfunction ◽  
Line Therapy ◽  
Increased Risk ◽  
History Of Use

Hyperprolactinaemia is characterised by gonadal dysfunction, including infertility and reduced libido and, if left untreated, is associated with an increased risk of long-term complications, such as osteoporosis. The first-line therapy for patients with hyperprolactinaemia is pharmacological intervention with a dopamine agonist. Currently, there are three dopamine agonists available for hyperprolactinaemia therapy: bromocriptine, quinagolide and cabergoline. Bromocriptine has a long history of use; however, a range of 5–18% of patients are reported to show bromocriptine resistance, with only partial lowering of plasma prolactin levels and an absence of tumour shrinkage. The newer dopamine agonists, quinagolide and cabergoline, offer improved efficacy over bromocriptine, with a lower incidence of adverse events. Quinagolide and cabergoline have also demonstrated efficacy in many patients intolerant or resistant to bromocriptine. Thus, the selection of dopamine agonists available provides more than one option for pharmacological intervention of hyperprolactinaemia. This review discusses the clinical use of quinagolide in comparison to other dopamine agonists for hyperprolactinaemia therapy. Quinagolide may improve patient compliance to treatment owing to its reduced side effect profile, simple and rapid titration over just 7 days, once-daily dosing regimen and easy to use starter pack (available in some countries). Quinagolide offers an additional benefit for patients wishing to become pregnant, as it can be used until the point of confirmation of pregnancy. Therefore, as a well tolerated and effective therapy, with a simple dosing regimen, quinagolide should be considered as a first-line therapy in the treatment of hyperprolactinaemia.

Somatostatin receptor ligands induce TSH deficiency in thyrotropin-secreting pituitary adenoma

2021 ◽  
Vol 184 (1) ◽  
pp. 1-8
Author(s):  
Frédéric Illouz ◽  
Philippe Chanson ◽  
Emmanuel Sonnet ◽  
Thierry Brue ◽  
Amandine Ferriere ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Somatostatin Receptor ◽  
Receptor Ligands ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Somatostatin Receptor Ligands ◽  
Central Hyperthyroidism ◽  
Long Acting ◽  
Tsh Deficiency

Objective Somatostatin receptor ligands (SRL) are useful to control central hyperthyroidism in patients with thyrotropin-secreting pituitary adenoma (TSH pituitary adenoma). The aim of this study was to describe the frequency of thyrotropin deficiency (TSH deficiency) in patients with TSH pituitary adenoma treated by SRL. Design Retrospective study. Methods Patients with central hyperthyroidism due to TSH pituitary adenoma treated by short or long-acting SRL were retrospectively included. TSH deficiency was defined by a low FT4 associated with non-elevated TSH concentrations during SRL therapy. We analysed the frequency of TSH deficiency and the characteristics of patients with or without TSH deficiency. Results Forty-six patients were included. SRL were used as the first-line therapy in 21 of 46 patients (46%). Central hyperthyroidism was controlled in 36 of 46 patients (78%). TSH deficiency appeared in 7 of 46 patients (15%) after a median time of 4 weeks (4–7) and for a median duration of 3 months (2.5–3). The TSH deficiency occurred after one to three injections of long-acting SRL used as first-line therapy in 6/7 cases. There were no differences in terms of clinical and hormonal features, size of adenomas or doses of SRL between patients with or without TSH deficiency. Conclusions SRL can induce TSH deficiency in patients with central hyperthyroidism due to TSH pituitary adenoma. Thyrotropic function should be assessed before the first three injections of SRL in order to track TSH deficiency and reduce the frequency of injections when control of thyrotoxicosis rather than tumour reduction is the aim of the treatment.

scholarly journals Review of the Treatment of Restless Legs Syndrome: Focus on Gabapentin Enacarbil

2012 ◽  
Vol 4 ◽  
pp. JCNSD.S9107 ◽  
Author(s):  
Rachel A. Burke ◽  
Michele A. Faulkner
Keyword(s):  
Clinical Trials ◽  
Restless Legs Syndrome ◽  
Dopamine Agonists ◽  
First Line ◽  
Gabapentin Enacarbil ◽  
Restless Legs ◽  
First Line Therapy ◽  
Line Therapy ◽  
Dopaminergic Agent

The FDA approved gabapentin enacarbil in 2011 as the first non-dopaminergic agent for the treatment of restless legs syndrome (RLS) symptoms. Although gabapentin enacarbil is a pro-drug of gabapentin, its pharmacokinetics differ. Absorption of gabapentin enacarbil is more predictable, and inter-patient variability in bioavailability is lower than that of gabapentin. Studies have demonstrated superiority of gabapentin enacarbil compared to placebo. Comparisons to currently available RLS treatments are lacking, but clinical trials demonstrate comparable improvement in RLS symptoms to the dopamine agonists ropinirole and pramipexole, which are usually considered first-line therapy for daily RLS symptoms. Gabapentin enacarbil was well tolerated in clinical trials. The role of the drug in RLS treatment remains undefined, although it will likely be used as an alternative for refractory RLS when other treatments have failed. Additionally, gabapentin enacarbil may be recommended for patients with daily RLS symptoms that are less intense or are associated with pain as an alternative to dopamine agonists.

1904: Outcomes of Large Renal Calculi (>2-Cm) Treated with ESWL as First Line Therapy

2004 ◽  
Vol 171 (4S) ◽  
pp. 503-503
Author(s):  
Richard Vanlangendock ◽  
Ramakrishna Venkatesh ◽  
Jamil Rehman ◽  
Chandra P. Sundaram ◽  
Jaime Landman
Keyword(s):  
Renal Calculi ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

Is digoxin still justifiable as single first-line therapy in fetal SVT associated with fetal hydrops?

2008 ◽  
Vol 68 (S 01) ◽  
Author(s):  
DJ Kersten ◽  
J McDougall ◽  
C Schuller ◽  
JP Pfammatter ◽  
L Raio ◽  
...  
Keyword(s):  
First Line ◽  
Fetal Hydrops ◽  
First Line Therapy ◽  
Line Therapy

EFFICACY OF MODIFIED BISMUTH QUADRUPLE THERAPY (RBMA) AS FIRST-LINE THERAPY FOR ERADICATION OF HELICOBACTER PYLORI IN PATIENTS WITH CHRONIC GASTRITIS

2019 ◽  
pp. 28-32
Author(s):  
Van Huy Tran
Keyword(s):  
Helicobacter Pylori ◽  
Adverse Effects ◽  
Chronic Gastritis ◽  
Eradication Rate ◽  
High Rate ◽  
First Line ◽  
Helicobacter Pylori Eradication ◽  
Quadruple Therapy ◽  
First Line Therapy ◽  
Line Therapy

Background and aims: Efficacy with substitution of tetracycline with amoxicillin, an antibiotics having a very low resistance rate and a high tolerability, in bismuth quadruple therapy (BQT) have not been studied in Vietnam. Our study aimed to evaluate the efficacy and tolerability of modified BQT vs. standard BQT for first-line Helicobacter pylori eradication. Patients and methods: This is a randomized, prospective study. 120 patients with H.pylori positive-chronic gastritis were randomly divided into two groups. The RBMA group containing rabeprazole 20 mg, bismuth subsalicylic 524mg, metronidazole 500mg, amoxicillin 1000mg, all 2 times a day, for 14 days. The RBMT group received rabeprazole, bismuth subsalicylic, metronidazole and tetracycline. Evaluation for compliance and drug-related side effects were evaluated at the end of two weeks. 4-6 weeks after the end of treatment, the H.pylori eradication rate was determined by the C13urease breath test. Results: Eradication rate was not statistically significative different between the RBMA and the RBMT: 91.2%; 95% confidence interval, 78.2% - 96.7%) vs. 90%; 95% CI, 81.6% - 96.3%) by per-protocol analysis (p = 0.42) and 86.7% (95%CI, 75.84% - 93.09%) vs. 75% (95%CI, 62.1% - 85.3%) by intention-to-treat analysis (ITT, p = 0.06). Adverse effects were significant higher in the RBMT group than in the RBMA group (48.3% vs. 26.7%; p = 0.071) and rate of good compliance was significantly higher in RBMA group than in RBMT group (p < 0.05). Conclusion: The modified BQT including rabeprazole, bismuth, metronidazole and amoxicillin achieved a fairly high rate of H.pylori infection eradication with a higher compliance and lower rate of adverse effects compared to the BQT in patients with chronic gastritis. Further studies need to conduct to confirm this new regimens as a first-line therapy in our country. Key words: Modified bismuth quadruple therapy, BQT, Helicobacter pylori eradication

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