Shulman L M
University of Miami School of Medicine, Miami, Florida 33136, USA.
Eur J Neurol. 2000 May;7 Suppl 1:9-13. doi: 10.1046/j.1468-1331.2000.0070s1009.x.
Dopamine receptor agonists are assuming increased importance in the treatment of both early and advanced symptoms of Parkinson's disease (PD). However, tolerability of these drugs can be a problem. Identifying patients who are at increased risk of adverse effects is central to using dopamine agonists in PD. The newer agonists, pramipexole and ropinirole, are generally adequate without levodopa for early symptoms and carry the hope for a more acceptable profile of long-term side-effects. In the patient with advanced disease, all four dopamine agonists significantly augment the response to levodopa, which reduces the problems of motor fluctuations and drug related dyskinesia. Understanding the common pitfalls when prescribing these drugs will facilitate their safety and efficacy.
多巴胺受体激动剂在帕金森病（PD）早期和晚期症状的治疗中发挥着越来越重要的作用。然而，这些药物的耐受性可能是个问题。识别出不良反应风险增加的患者是在帕金森病中使用多巴胺激动剂的关键。新型激动剂普拉克索和罗匹尼罗，对于早期症状通常无需左旋多巴就足够有效，并且有望带来更易于接受的长期副作用情况。对于晚期疾病患者，所有四种多巴胺激动剂都能显著增强对左旋多巴的反应，从而减少运动波动和药物相关异动症的问题。了解开具这些药物时常见的陷阱将有助于提高其安全性和疗效。
