Del Dotto P, Colzi A, Pardini C, Lucetti C, Dubini A, Grimaldi R, Bonuccelli U
Institute of Clinical Neurology, University of Pisa, Italy.
J Neural Transm Suppl. 1995;45:259-65.
Studies on the influence of some dopamine agonists, particularly bromocriptine, on the pharmacokinetics of L-dopa have furnished contrasting results. Thus, any possible pharmacokinetic interaction should be taken into consideration when adding a new dopamine agonist to L-dopa treatment. In 12 Parkinson's disease (PD) patients with motor fluctuations, cabergoline was added in an 8-week study to their usual L-dopa/carbidopa therapy. Cabergoline was administered once a day at increasing doses of 0.5, 1, 2, and 3mg/day for a period of one week per dose, and 4mg/day for three weeks. Motor performance was assessed weekly evaluating the motor examination of the Unified Parkinson's Disease Rating Scale (UPDRS) and the patients' diaries of daily on-off time. Blood levels of both L-dopa and 3-O-methyldopa (3-OMD) were assayed by HPLC in two different days, over an 8-hour period, before initiating cabergoline and at the end of the study. The results of this study confirm that cabergoline is effective in the management of PD motor fluctuations without modifying L-dopa and 3-OMD pharmacokinetics.
关于某些多巴胺激动剂，尤其是溴隐亭，对左旋多巴药代动力学影响的研究得出了相互矛盾的结果。因此，在左旋多巴治疗中添加新的多巴胺激动剂时，应考虑任何可能的药代动力学相互作用。在一项为期8周的研究中，对12例有运动波动的帕金森病（PD）患者，在其常规左旋多巴/卡比多巴治疗基础上加用卡麦角林。卡麦角林每天给药一次，剂量递增，分别为0.5、1、2和3mg/天，每个剂量持续一周，4mg/天持续三周。每周通过评估统一帕金森病评定量表（UPDRS）的运动检查和患者的日常开-关时间日记来评估运动表现。在开始使用卡麦角林之前和研究结束时，在两个不同的日子里，通过HPLC在8小时内测定左旋多巴和3-O-甲基多巴（3-OMD）的血药浓度。这项研究的结果证实，卡麦角林在治疗PD运动波动方面有效，且不会改变左旋多巴和3-OMD的药代动力学。
