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Academia Mexicana de Neurología, A.C.

2018, Número 3

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Rev Mex Neuroci 2018; 19 (3)


Contexto histórico de los agonistas dopaminérgicos

Estrada-Bellmann I, Cámara-Lemarroy C, Delgado-García G, Cerda-Contreras C

Idioma: Español
Referencias bibliográficas: 69
Paginas: 74-84
Archivo PDF: 163.50 Kb.


RESUMEN

Introducción: Al corto tiempo de la introducción de la levodopa en la terapéutica de la EP, se volvió claro que su uso crónico se asociaba con efectos adversos. Considerando que los agonistas dopaminérgicos (AD) actúan directamente sobre el sistema nigroestriado y que sus vidas medias son más prolongadas, se hipotetizó que utilizándolos podrían evitarse estos efectos adversos.
Objetivo: Realizar una revisión narrativa acerca del desarrollo históricos de los AD.
Desarrollo: Aun cuando los AD han sido utilizados en el tratamiento de la EP sólo desde la década de los setenta, a principios del siglo pasado ya existían reportes sobre los efectos de la apomorfina. La búsqueda de fármacos moduladores de la prolactina llevo al descubrimiento de la bromocriptina, un AD derivado del ergot, en los años sesenta. Su utilidad en la EP se estableció en la década siguiente. En las últimas dos décadas del siglo pasado hubo un marcado avance con el desarrollo de AD no ergotamínicos (e.g., ropinirol, pramipexol y rotigotina). Actualmente el uso de éstos está en aumento gracias a su perfil más favorable. Sin embargo, estos AD se asocian a otras complicaciones.
Conclusiones: Como monoterapia, los AD no ergotamínicos son una alternativa segura en la EP temprana y en pacientes jóvenes. No obstante, suelen administrarse conjuntamente con levodopa en la EP avanzada. El desarrollo de nuevos AD continúa y esto ha permitido profundizar en el conocimiento de los receptores dopaminérgicos, posibilitando así la creación de fármacos más selectivos y específicos.


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