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- Apomorphine (3)
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Apomorphine
From Wikipedia, the free encyclopedia
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Apomorphine
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| Systematic (IUPAC) name | |
| 5,6,6a,7-Tetrahydro-6-methyl-4H- dibenzo[de,g]quinolin-10,11-diol (?) | |
| Identifiers | |
| CAS number | |
| ATC code | G04 N04BC07 |
| PubChem | |
| DrugBank | |
| Chemical data | |
| Formula | C17H17NO2 |
| Mol. mass | 267.322 g/mol |
| Pharmacokinetic data | |
| Bioavailability | 100% following sc injection |
| Protein binding | ~50% |
| Metabolism | hepatic |
| Half life | 40 minutes (range 30-60 minutes) |
| Excretion | ? |
| Therapeutic considerations | |
| Pregnancy cat. |
? |
| Legal status | |
| Routes | sc |
Apomorphine is a type of dopaminergic agonist, a morphine derivative (but does not actually contain morphine). Apomorphine is a relatively non-selective dopamine receptor agonist, having possible slightly higher affinity for D2-like dopamine receptors.
Historically, apomorphine has been tried for a variety of uses including psychiatric treatment of homosexuality in the early 20th century. Currently, apomorphine is used in the treatment of Parkinson's disease and erectile dysfunction. It was also successfully used in the treatment of heroin addiction, a purpose for which it was championed by the author William S. Burroughs. It is a potent emetic, meaning that it should not be administered without an antiemetic such as domperidone. The emetic properties of apomorphine are exploited in veterinary medicine to induce therapeutic emesis in canines that have recently ingested toxic or foreign substances.
For treatment of erectile dysfunction, it is believed that dopamine receptors in the hypothalamic region of the brain are the main target, as although dopamine receptors in the penis do facilitate erection, they do so far more weakly than those in the brain.[1]
Apomorphine is clear as a liquid but stains green. Therefore care must be taken to avoid splashes. Apormophine does not remain stable for more than 24 hours in a plastic container, so glass syringes are used.
First mooted as a treatment for Parkinson's disease as early as 1951,[2] its clinical use was first reported in 1970 by Cotzias et al,[3] although its emetic properties and short half-life made oral use impractical. A later study found that combining the drug with the antiemetic domperidone, improved results significantly.[4]
Therapeutic use in Parkinson's disease is effective because of the drugs strong dopaminergic action, with a rapid effect (within 3-20 minutes of injection) but a brief duration.[5] Whilst apomorphine can be used in combination with l-dopa, the intention is usually to wean patients off of this, as by this stage they will probably be experiencing a great deal of dopa-induced dyskinesias and "off" periods.[5] Following a successful apomorphine challenge, training of patient and caregiver, and careful dose titration, there is no reason why an apomorphine pump can not be an effective monotherapy.[5]
- a Matsumoto K, Yoshida M, Andersson K, Hedlund P (2005). "Effects in vitro and in vivo by apomorphine in the rat corpus cavernosum.". Br J Pharmacol 146 (2): 259-67. PMID 16025145.
- a Schwab R, Amador L, Lettvin J. "Apomorphine in Parkinson's disease.". Trans Am Neurol Assoc 56: 251-3. PMID 14913646.
- a Cotzias G, Papavasiliou P, Fehling C, Kaufman B, Mena I (1970). "Similarities between neurologic effects of L-dopa and of apomorphine.". N Engl J Med 282 (1): 31-3. PMID 4901383.
- a Corsini G, Del Zompo M, Gessa G, Mangoni A (1979). "Therapeutic efficacy of apomorphine combined with an extracerebral inhibitor of dopamine receptors in Parkinson's disease.". Lancet 1 (8123): 954-6. PMID 87620.
- a b c Chaudhuri K, Clough C (1998). "Subcutaneous apomorphine in Parkinson's disease.". BMJ 316 (7132): 641. PMID 9522772.
- PDSP Ki database
- Apomorphine - Frequently Asked Questions. Britannia Pharmaceuticals.
- Andrew Lees and Kirsten Turner (2002). "Apomorphine for Parkinson’s Disease" (PDF). Practical Neurology 2: 280-287. DOI:10.1046/j.1474-7766.2002.00086.x. - Detailed usage guide for Apomorphine pumps for Parkinson's
- Links to external chemical sources
| Urologicals (G04) | |
|---|---|
| Acidifiers | Ammonium chloride, Calcium chloride |
| Urinary antispasmodics | Darifenacin, Emepronium, Flavoxate, Meladrazine, Oxybutynin, Propiverine, Solifenacin, Terodiline, Tolterodine, Trospium |
| For erectile dysfunction | Alprostadil, Apomorphine, Avanafil, Moxisylyte, Papaverine, Phentolamine, Sildenafil, Tadalafil, Udenafil, Vardenafil, Vendafidel, Yohimbine |
| Other urologicals | Acetohydroxamic acid, Collagen, Dimethyl sulfoxide, Magnesium hydroxide, Phenazopyridine, Phenyl salicylate, Succinimide |
| For benign prostatic hypertrophy | 5α-reductase inhibitors: Dutasteride, Finasteride Alpha blockers: Alfuzosin, Doxazosin, Tamsulosin, Terazosin |