Agonistas Dopaminérgicos no tratamento da Doença de Parkinsons
DOI:
https://doi.org/10.34024/rnc.2004.v12.8850Palavras-chave:
Doença de Parkinson, Agonistas dopaminérgicos, Levodopa, NeuroproteçãoResumo
A doença de Parkinson (DP) é a doença neurodegenerativa mais freqüente na população depois da doença de Alzheimer e é fonte de grave incapacitação para um grande número de pessoas. A doença é resultado de uma degeneração de neurônios da substância negra ocasionando uma deficiência de dopamina no corpo estriado. A reposição dopaminérgica com a levodopa, uma droga precursora da dopamina, é a pedra angular do tratamento da DP. Os agonistas dopaminérgicos (AD) são drogas que ativam diretamente os receptores de dopamina sem a necessidade de ser metabolizada pelo neurônio pré-sináptico. Há duas classes de AD, os ergolínicos e os não ergolínicos. Os derivados do ergot são a bromocriptina, pergolida, lisurida e cabergolina. Os não ergolínicos são a apomorfina, o pramipexol, ropinirol e o piribedil. O pramipexol e o ropinirol são mais bem tolerados que os demais. Embora menos potentes que a levodopa, os AD são eficazes na fase inicial da DP e permitem que se reduzam a incidência de complicações de longo prazo associados à levodopa, como as flutuações motoras e as discinesias. No tratamento da fase avançada da DP, são drogas úteis como coadjuvantes da levodopa minimizando as complicações. Há evidências recentes de que a utilização precoce dos AD, pramipexol e ropinirol, na DP poderia exercer um efeito neuroprotetor
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Publicado: 2004-12-31
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