Kontent qismiga oʻtish

Bromocriptine

Vikipediya, ochiq ensiklopediya

Bromokriptin dastlab Parlodel nomi ostida sotilgan keyinchalik koʻplab brend nomlari ostida sotuvga chiqarilgan.[1] Ergolin hosilasi dofamin agonisti boʻlib, u gipofiz oʻsmalari, Parkinson kasalligi, giperprolaktinemiya, neyroleptik malign sindrom va 2-turdagi qandli diabetni davolashda qoʻllanadi.

Bromokriptin 1968-yilda patentlangan va 1975-yilda tibbiy foydalanishga ruxsat berilgan.[2]

Tibbiy maqsadlarda foydalanish

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Bromokriptin akromegaliya va amenoreya, bepushtlik, gipogonadizm va prolaktin ajraladigan adenoma kabi giperprolaktinemiya bilan bog'liq kasalliklarni davolash uchun foydalaniladi. Shuningdek, u tuxumdonlar giperstimulyatsiyasi sindromining oldini olish uchun[3][4] va Parkinson kasalligini davolash uchun ishlatiladi.

1980-yillarning oxiridan beri u kokain alomatlarini kamaytirish uchun ishlatilgan, ammo bu usulda foydalanish uchun isbotlar kam.[5]

Bromokriptinning formulasi, sikloset ham 2-toifa diabetni davolash uchun ishlatiladi.[6][7] Uyg'onganidan keyin 2 soat ichida qo'llanilganda, u gipotalamusdagi dofamin darajasini oshiradi va natijada jigarda glyukoza ishlab chiqarishni kamaytiradi. Shuning uchun u glyukemik nazoratni yaxshilash uchun parhez va jismoniy mashqlar uchun qo'shimcha sifatida iste'mol qilinishi mumkin.[8]

Nojo‘ya ta'sirlari

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Eng ko'p uchraydigan nojo'ya ta'sirlarga ko'ngil aynishi, ortostatik gipotenziya, bosh og'rig'i va qusish markazini stimulyatsiya qilish orqali qayt qilishdir.[9] Miyokard infarkti va insult kabi jiddiy oqibatlarga olib keladigan vazospazmlar tug'ruq davri bilan bog'liq bo'lib, juda kam uchraydigan hodisalardir.[10] Periferik vazospazm (barmoqlar yoki oyoq barmoqlari) Raynaud fenomeniga olib kelishi mumkin. Bromokriptinni qo'llash psixotik simptomlarni keltirib chiqarishi yoki yomonlashishi bilan bog'liq (uning mexanizmi ko'pchilik antipsikotiklarga qarama-qarshidir, ularning mexanizmlari odatda dopamin retseptorlarini bloklaydi).[11] Bromokriptin Parkinson kasalligini davolash uchun yuqori dozalarda qo'llanilganda o'pka fibrozi haqida xabar berilgan.[12]

Tuqqandan keyin sut ishlab chiqarishni to'xtatish uchun foydalanish 2014-yilda ko'rib chiqildi va bu kontekstda jiddiy yurak-qon tomir, nevrologik yoki psixiatrik hodisalar bilan sababiy bog'liqlikni istisno qilib bo'lmaydi, degan xulosaga keldi, umumiy insidans 0,005% dan 0,04% gacha. Ma'lumotlarga asoslanib, qo'shimcha xavfsizlik choralari va qat'iyroq retseptlash qoidalari taklif qilindi.[13][14] Bu safro tuzining eksport pompasi inhibitori.[15]

Dofamin agonistlarini uzoq muddat qabul qilgandan keyin, dozani kamaytirish yoki qabul qilishni to'xtatish paytida quyidagi nojo'ya ta'sirlar kelib chiqadi : tashvish, vahima hurujlari , disforiya, depressiya, qo'zg'alish, asabiylashish, o'z joniga qasd qilish fikri, charchoq, ortostatik gipotenziya, ko'ngil aynishi, qusish., diaforez, umumiy og'riq va giyohvand moddalarga bo'lgan ishtiyoq. Ba'zi odamlar uchun bu nojo'ya ta'sirlar qisqa muddatli bo'lib, ular to'liq tuzalib ketadi, boshqalar uchun uzoq davom etadigan nojo'ya ta'sirlar paydo bo'lishi mumkin, bu bu nojo'ya ta'sirlar oylab yillab davom etishi mumkin.[16]

Farmakologiya

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Farmakodinamikasi

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Dopamin retseptorlari bilan bog'langan konformatsiyada bormokriptin

Bromokriptin dofamin D <sub id="mwXg">2</sub> retseptorining qisman agonistidir.[17] Bundan tashqari, boshqa dofamin retseptorlari va turli xil serotonin va adrenergik retseptorlari bilan o'zaro ta'sir qiladi. Bromokriptin qo'shimcha ravishda GLT1 glutamat tashuvchisini teskari o'zgartirib, glutamatning tarqalishini ingibatsiya qilgani aniqlangan.[18]

Serotonin 5-HT <sub id="mweA">2B</sub> retseptorlarining antagonisti sifatida bromokriptin yurak valvulopatiyasi bilan bog'liq emas.[19] Bu kabergolin va pergolid kabi 5-HT 2B retseptorlari agonistlari vazifasini bajaradigan boshqa ergolinlardan farqli o'laroq, lekin xuddi shunday tarzda 5-HT 2B retseptorlari antagonisti vazifasini bajaradigan lizuridga o'xshaydi.[19]

Activities of bromocriptine at various sites[20][21][22][23]
Site Affinity (Ki [nM]) Efficacy (Emax [%]) Action
D<sub id="mwmw">1</sub> 692 ? ?
D<sub id="mwpA">2S</sub> 5.0 41 Partial agonist
D<sub id="mwqw">2L</sub> 15 28 Partial agonist
D<sub id="mwsg">3</sub> 6.8 68 Partial agonist
D<sub id="mwuQ">4</sub> 372 0 Silent antagonist
D<sub id="mwwA">5</sub> 537 ? ?
5-HT<sub id="mwyQ">1A</sub> 13 72 Partial agonist
5-HT<sub id="mw0A">1B</sub> 355 66 Partial agonist
5-HT<sub id="mw1w">1D</sub> 11 86 Partial agonist
5-HT<sub id="mw3g">2A</sub> 107 69 Partial agonist
5-HT<sub id="mw5Q">2B</sub> 56 0 Silent antagonist
5-HT<sub id="mw7A">2C</sub> 741 79 Partial agonist
5-HT<sub id="mw8w">6</sub> 33 ? ?
5-HT<sub id="mw_A">7</sub> 11–126 ? ?
α<sub id="mwAQU">1A</sub> 4.2 0 Silent antagonist
α<sub id="mwAQw">1B</sub> 1.4 ? ?
α<sub id="mwARU">1D</sub> 1.1 ? ?
α<sub id="mwAR4">2A</sub> 11 0 Silent antagonist
α<sub id="mwASU">2B</sub> 35 0 Silent antagonist
α<sub id="mwASw">2C</sub> 28 0 Silent antagonist
α<sub id="mwATM">2D</sub> 68 ? ?
β<sub id="mwATw">1</sub> 589 ? ?
β<sub id="mwAUU">2</sub> 741 ?
H<sub id="mwAU4">1</sub> >10,000
M<sub id="mwAVU">1</sub> >10,000

Barcha ergopeptidlar singari, bromokriptin ham sikloldir ; uning tripeptid qismining ikkita peptid guruhi o'zaro bog'langan bo'lib, amid funksionalligi bilan ikkita halqa o'rtasida >NC(OH)< birikmasini hosil qiladi.

Bromokriptin - N -bromosuksid yordamida ergokriptinni bromlash yo'li bilan sintez qilinadigan tabiiy ergot alkaloidi, ergokriptin (lisergik kislota hosilasi) ning yarim sintetik hosilasi hisoblanadi.

Bromokriptin 1965-yilda Sandoz tomonidan kashf etilgan va birinchi marta 1968-yilda patentlangan birinchi marta Parlodel brendi ostida sotuvga chiqarilgan.[24][25]

Bromokriptinning formulasi 2009-yilda FDA tomonidan tasdiqlangan[26]

Jamiyat va madaniyat

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Brend nomlari

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2017-yil iyul oyidan boshlab bromokriptin butun dunyo bo'ylab ko'plab brendlar ostida sotildi, jumladan Abergin, Barlolin, Brameston, Brocriptin, Brom, Broma-Del, Bromergocryptine, Bromergon, Bromicon, Bromocorn, Bromocriptin, Bromocriptina, Bromocriptine, Bromocriptina, Bromocriptine, Bromocriptina, Bromocriptine, Bromocriptine, Bromocriptine, Bromocriptemes, metansulfonat, bromokriptin mesilas, bromokriptinmesilat, bromodel, bromokriptin, bromolac, bromotin, bromtin, brotin, butin, korpadel, kripsa, kriptin, kriten, sikloset, degala, demil, deparo, deprolak, dokriptin, kiriptin, diakriptin,, Kriptonal, Laktodel, Medokriptin, Melen, Padoparin, Palolactin, Parlodel, Pravidel, Proktinal, Ronalin, Yarim Brom, Serokriptin, Serokriptin, Suplac, Sintokriptin, Umprel, Unew, Updopa, Upnol B va Volbro.[1]

2017-yil iyul oyidan boshlab u Diakriptin-M sifatida metformin bilan kombinatsiyalangan dori sifatida va Pseudogravin brendi ostida veterinariya preparati sifatida sotilgan.[1]

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