BROMOCRIPTINA â€“.ppt

7/21/2019 BROMOCRIPTINA .ppt

1/19

BROMOCRIPTINA BROMOCRIPTINA o nou terapie n DZ tipo nou terapie n DZ tip

22

Med. Rez. Endocrinoo!ieMed. Rez. Endocrinoo!ieMerean TeodoraMerean Teodora


2/19

Dia"etu za#arat tip 2 e$te o a%ec&iuneDia"etu za#arat tip 2 e$te o a%ec&iune'eta"oic cronic caracterizat prin'eta"oic cronic caracterizat prinin$uino(rezi$ten&) a%ectarea %unc&iei ceueiin$uino(rezi$ten&) a%ectarea %unc&iei ceuei"eta pancreatice) aterarea $ecre&iei de"eta pancreatice) aterarea $ecre&iei de!uca!on) a $i$te'uui incretineor precu' *i!uca!on) a $i$te'uui incretineor precu' *iate nu'eroa$e 'odi+cri 'eta"oice *iate nu'eroa$e 'odi+cri 'eta"oice *iendocrine.endocrine.

Continu cutare de a!en&i noi pentruContinu cutare de a!en&i noi pentrure$ta"iirea eu!ice'ieire$ta"iirea eu!ice'iei

Bro'ocriptina cu ei"erare rapid ,C-co$etBro'ocriptina cu ei"erare rapid ,C-co$et


3/19

Bro'ocriptinaBro'ocriptina

Deri/at de er!oin) a!oni$tDeri/at de er!oin) a!oni$tdopa'iner!ic ,D2 utiizat ndopa'iner!ic ,D2 utiizat ntrata'entutrata'entu

( tu'orior #ipo+zare( tu'orior #ipo+zare( #iperproactine'iei( #iperproactine'iei

( ". Par0in$on( ". Par0in$on

( $dr. neuroeptic 'ai!n( $dr. neuroeptic 'ai!n( DZ tip 2 ,1DA (23( DZ tip 2 ,1DA (23


4/19


5/19

B. nu are receptor $peci+c de 'ediere aB. nu are receptor $peci+c de 'ediere a'eta"oi$'uui 4 *i 5 ci re$eteaz'eta"oi$'uui 4 *i 5 ci re$eteaztonu$u dopa'iner!ic *i $i'patic din 6NCtonu$u dopa'iner!ic *i $i'patic din 6NC

Mode ani'aMode ani'ade aternan& in$uino(de aternan& in$uino($en$i"iitate 7 in$uino(rezi$ten&.$en$i"iitate 7 in$uino(rezi$ten&.

8i"ernarea 9 !ucozo intoeran& :8i"ernarea 9 !ucozo intoeran& :!uconeo!enez : ipoiz cre$cut!uconeo!enez : ipoiz cre$cut

8i"ernarea ;9 N6C 8-T ,centru8i"ernarea ;9 N6C 8-T ,centru

circadian a 'a'i%ereor *i 8


6/19

88

N6C= dopa'ina $cade ( IRN6C= dopa'ina $cade ( IR,di$tru!ere neuroni dopa'iner!ici 9? IR $e/er,di$tru!ere neuroni dopa'iner!ici 9? IR $e/er

PE< cu B duce a $cderea NA:$erotoninPE< cu B duce a $cderea NA:$erotonindin 8


7/19

Modeu u'anModeu u'an

Aceea*i 'odi+cri 'eta"oice $e re!$e$c *i a per$oanee cuAceea*i 'odi+cri 'eta"oice $e re!$e$c *i a per$oanee cuIR7DZ tip 2IR7DZ tip 2

Nu e@i$t 'arcate o$cia&ii circadiene 7 $ezoniere aeNu e@i$t 'arcate o$cia&ii circadiene 7 $ezoniere ae'eta"oi$'uui'eta"oi$'uui

Ni/eurie de 'onoa'ine din 8-T $unt $u" controuNi/eurie de 'onoa'ine din 8-T $unt $u" controu.. 6ti'ui %otici ,c#ia$'a optic6ti'ui %otici ,c#ia$'a optic2.2. $ti'ui tract !a$trointe$tina$ti'ui tract !a$trointe$tina.. #or'oni#or'oni.. 'eta"oi&i circuan&i'eta"oi&i circuan&i

O"ezitatea non$ezonier 9? $cdare per'anent a dopa'ineiO"ezitatea non$ezonier 9? $cdare per'anent a dopa'inei

Per$oanee cu dia"et za#arat tip 2 au o $cdere 'atina precoce aPer$oanee cu dia"et za#arat tip 2 au o $cdere 'atina precoce atonu$uui dopa'iner!ic care duce a cre*terea acti/it&ii $i'patice.tonu$uui dopa'iner!ic care duce a cre*terea acti/it&ii $i'patice.

IR7DZ tip 2 ( ni/euri diurne cre$cute de proactin ,2 /$ I6 ( PR5IR7DZ tip 2 ( ni/euri diurne cre$cute de proactin ,2 /$ I6 ( PR5

e u*or cre$cut nocturne u*or cre$cut nocturn


8/19

DezideratDeziderat

Ad'ini$trarea $i$te'ic aAd'ini$trarea $i$te'ic a

"ro'ocriptinei $ '"unt&ea$c"ro'ocriptinei $ '"unt&ea$ccontrou !ice'ic *i di$ipide'ia acontrou !ice'ic *i di$ipide'ia apacien&ii cu DZ tip 2 *i a pacien&iipacien&ii cu DZ tip 2 *i a pacien&iio"ezio"ezi


9/19


10/19

1ar'acocinetic *i po$oo!ie1ar'acocinetic *i po$oo!ie

Bro'ocriptin 'e$iat ,C-co$et cpr ) '!Bro'ocriptin 'e$iat ,C-co$et cpr ) '!

( ei"erare rapidei"erare rapid

( FG(3G H a"$or"&ieFG(3G H a"$or"&ie( pri'u pa$a #epatic ,citocro' PG c-ppri'u pa$a #epatic ,citocro' PG c-p

A 9? G( H aun!e n circua&iaA 9? G( H aun!e n circua&ia$i$te'ic$i$te'ic

( pea0 pa$'atic a F 'inpea0 pa$'atic a F 'in

( 3 H e!at de proteine pa$'atice3 H e!at de proteine pa$'atice

( T72 F #T72 F #

( 3 H ei'inare "iiar) re$tu urinar3 H ei'inare "iiar) re$tu urinar


11/19

Ini&iere ) '!7zi , cprIni&iere ) '!7zi , cpr

CreJtere cu cpr7$ptCreJtere cu cpr7$pt Ma@ de ) '!7zi , F cpr Ma@ de ) '!7zi , F cpr

Doza unic di'inea&a n pri'ee dou ore deDoza unic di'inea&a n pri'ee dou ore dea trezire) a di$tan& de 'e$ea trezire) a di$tan& de 'e$e

Nu $(au e%ectuat $tudii pe pacien&i cuNu $(au e%ectuat $tudii pe pacien&i cu

patoo!ie rena re$pecti/ #epatic ( $e indicpatoo!ie rena re$pecti/ #epatic ( $e indicprecau&ieprecau&ie


12/19

/$/$

Endocrinoo!i

4inecoo!i

Neuroo!i

Cardioo!i

Dia"etoo!i


13/19

6tudii de %aza ( 1DA6tudii de %aza ( 1DA

6(au e%ectuat $tudii pentru6(au e%ectuat $tudii pentrue+cacitate=e+cacitate=

.. 2 $pt 'onoterapie2 $pt 'onoterapie

2.2. 2 $pt B:6K ,2 $tudii2 $pt B:6K ,2 $tudii.. G2 $pt B:ADO7in$uinG2 $pt B:ADO7in$uin

Concuzii= 8"Ac $cade cu )G()L H aConcuzii= 8"Ac $cade cu )G()L H a

pacien&ii trata&i cu B indi%erent depacien&ii trata&i cu B indi%erent deco'"ina&ia ADO) 4A $cade cu o 'edieco'"ina&ia ADO) 4A $cade cu o 'ediede G '!7dde G '!7d

6tudii rando'izate) du"u or") pace"o controate 6tudii rando'izate) du"u or") pace"o controate


14/19

6TKDII6TKDII

6tudiu ,pacien&i o"ezi= #iperin$uine'ie> )F6tudiu ,pacien&i o"ezi= #iperin$uine'ie> )F'!7zi B. 2 $pt'ni 9'!7zi B. 2 $pt'ni 9??$cdere 4A *i 4PP)$cdere 4A *i 4PP)in$uine'ie cu GH> 4 ctin$uine'ie cu GH> 4 ct

6tudiu 2 ,pacien&i o"ezi= )F '!7zi B. $pt'ni6tudiu 2 ,pacien&i o"ezi= )F '!7zi B. $pt'ni99??$cdere !ice'ie) tri!iceride) acizi !ra*i) T4$cdere !ice'ie) tri!iceride) acizi !ra*i) T4

6tudiu ,pacien&i o"ezi cu DZ tip 2= )F '!7zi B.6tudiu ,pacien&i o"ezi cu DZ tip 2= )F '!7zi B.

F $pt'ni 9F $pt'ni 9??$cdere 4A cu G '!7d) 8"Ac$cdere 4A cu G '!7d) 8"Accu )2H) %r 'odi+care in$uine'ie $au !reutatecu )2H) %r 'odi+care in$uine'ie $au !reutate


15/19


16/19

T#e C-co$et 6a%et- Tria) a G2(ee0)T#e C-co$et 6a%et- Tria) a G2(ee0)rando'ized) dou"e("ind) 'uticenterrando'ized) dou"e("ind) 'uticenter

triatria

Reac&ii ad/er$eReac&ii ad/er$e 4re&uri4re&uri


17/19

B. *i e/eni'enteeB. *i e/eni'enteecardio/a$cuarecardio/a$cuare

6cdere a e/. c/. a pac. dia"etici trata&i6cdere a e/. c/. a pac. dia"etici trata&icu B. %r a eucida 'ecani$'ee inti'e.cu B. %r a eucida 'ecani$'ee inti'e.

TA) 1CTA) 1C

acti/it&ii 6N6 a$upra /a$cuaturiiacti/it&ii 6N6 a$upra /a$cuaturii, proi%erarea %'n din 'edie), proi%erarea %'n din 'edie)

$intetaza endoteia patoo!ic cre$cut$intetaza endoteia patoo!ic cre$cut

( $pecii reacti/e de O2( $pecii reacti/e de O2 A45) T4) !ice'ie.A45) T4) !ice'ie.


18/19

ConcuziiConcuzii

B. 'e$iat e$te un produ$ nou cuB. 'e$iat e$te un produ$ nou cu'ecani$' unic de ac&iune n'ecani$' unic de ac&iune npato!enia DZ tip 2 cu e+cacitatepato!enia DZ tip 2 cu e+cacitate

'ode$t a 'o'entu actua n$ cu'ode$t a 'o'entu actua n$ cupoten&ia) +ind nece$are 'ai 'utepoten&ia) +ind nece$are 'ai 'ute$tudii.$tudii.


19/19

Bi"io!ra+eBi"io!ra+e

De%ronzo RA. Bro'ocriptine= A $-'pat#o-tic) d2(De%ronzo RA. Bro'ocriptine= A $-'pat#o-tic) d2(dopa'ine a!oni$t %or t#e treat'ent o% t-pe 2dopa'ine a!oni$t %or t#e treat'ent o% t-pe 2dia"ete$.Dia"ete$ Care. 2>=L33.dia"ete$.Dia"ete$ Care. 2>=L33.

#ttp#ttp=77.nc"i.n'.ni#.!o/7p'c7artice$7PMCG2327=77.nc"i.n'.ni#.!o/7p'c7artice$7PMCG2327

#ttp=77.nc"i.n'.ni#.!o/7pu"'ed72F3FG#ttp=77.nc"i.n'.ni#.!o/7pu"'ed72F3FG

#ttp=77.nc"i.n'.ni#.!o/7pu"'ed72F3FG#ttp=77.nc"i.n'.ni#.!o/7pu"'ed72F3FG

#ttp#ttp=77.'ed$cape.co'7/ieartice7LL=77.'ed$cape.co'7/ieartice7LL #ttp=77.c-co$et.co'7#ttp=77.c-co$et.co'7
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152192/http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152192/http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152192/http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152192/http://www.ncbi.nlm.nih.gov/pubmed/21696353http://www.ncbi.nlm.nih.gov/pubmed/21696353http://www.ncbi.nlm.nih.gov/pubmed/23186965http://www.ncbi.nlm.nih.gov/pubmed/23186965http://www.medscape.com/viewarticle/740378http://www.medscape.com/viewarticle/740378http://www.medscape.com/viewarticle/740378http://www.medscape.com/viewarticle/740378http://www.medscape.com/viewarticle/740378http://www.medscape.com/viewarticle/740378http://www.ncbi.nlm.nih.gov/pubmed/23186965http://www.ncbi.nlm.nih.gov/pubmed/21696353http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152192/http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152192/

BROMOCRIPTINA â€“.ppt

Documents

Transcript of BROMOCRIPTINA â€“.ppt