Ropinirole, sold under the brand name Requip among others, is a medication used to treat Parkinsons disease (PD) and restless legs syndrome (RLS). In PD the dose needs to be adjusted to the effect and treatment should not be suddenly stopped. It is taken by mouth. It is approved in the US and UK for inducing emesis (vomiting) in dogs who have ingested toxins or non-sharp foreign material. Common side effects include sleepiness, vomiting, and dizziness. Serious side effects may include pathological gambling, low blood pressure with standing and hallucinations. Use in pregnancy and breastfeeding is of unclear safety. It is a dopamine agonist and works by triggering dopamine D2 receptors.It was approved for medical use in the United States in 1997. It is available as a generic medication. In 2019, it was the 144th most commonly prescribed medication in the United States, with more than 4 million prescriptions. In June 2020 it was approved for veterinary medical use in dogs in the US and UK. Medical uses
Ropinirole is prescribed for mainly Parkinsons disease, RLS and extrapyramidal symptoms. It can also reduce the side effects caused by selective serotonin reuptake inhibitors, including Parkinsonism syndrome as well as sexual dysfunction and erectile dysfunction caused by either SSRIs or antipsychotics. Dosage
Ropinirole is available in various preparations, ranging from a 0.25 mg tablet to a 5 mg tablet. The primary reason is dose titration. For Parkinsons disease, the maximum recommended dose is 24 mg per day, taken in three separate doses spread throughout the day.
People who have been treated with fludarabine will usually be asked to take co-trimoxazole or to use monthly nebulised pentamidine to prevent Pneumocystis jiroveci pneumonia. The profound lymphopenia caused by fludarabine renders patients susceptible to transfusion-associated graft versus host disease, an oftentimes fatal complication of blood transfusion. For this reason, all patients who have ever received fludarabine should only be given irradiated blood components. Fludarabine causes anemia, thrombocytopenia and neutropenia, requiring regular blood count monitoring. Some patients require blood and platelet transfusion, or G-CSF injections to boost neutrophil counts. Fludarabine is associated with the development of severe autoimmune hemolytic anemia in a proportion of patients.Difficulties are often encountered when harvesting peripheral blood stem cells from patients previously treated with fludarabine. Pharmacology
Fludarabine is a purine analog, and can be given both orally and intravenously. Fludarabine inhibits DNA synthesis by interfering with ribonucleotide reductase and DNA polymerase. It is active against both dividing and resting cells. Being phosphorylated, fludarabine is ionized at physiologic pH and is effectually trapped in blood. This provides some level of specificity for blood cells, both cancerous and healthy. History
Fludarabine was produced by John Montgomery and Kathleen Hewson of the Southern Research Institute in 1968. Names
Fludarabine is generally administered as its 5-O-phosphorylated form known as fludarabine phosphate, which is rapidly dephosphorylated to fludarabine in the plasma. References
External links
"Fludarabine". Drug Information Portal. U.S. National Library of Medicine.