Apomorphine

it is a non-selective dopamine agonist which activates both D1-like and D2-like receptors. It is potent emetic drug.

Indications

apomorphine hydrochloride injection) is indicated for the acute, intermittent treatment of hypomobility, “off” episodes (“end-of-dose wearing off” and unpredictable “on/off” episodes) in patients with advanced Parkinson's disease, Erectile dysfunction

Dosage

SC; 0.2ml(2mg) upto 0.6ml (6mg); upto 5 times a day Erectile dysfunction Adult: As hydrochloride: 2 mg/dose, approx 20 min before sexual activity, subsequent doses may be increased to 3 mg if necessary with a min of 8 hr between doses.

Contra-Indications

with concomitant use of 5HT3 antagonist class including antiemetics (e.g., ondansetron, granisetron, dolasetron, palonosetron), Hypersensitivity

Special Precautions

It should be initiated with the use of a concomitant antiemetic Paediatric: Safety and efficacy not yet established Pregnancy: Category C; should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus Lactation: Not known if secreted in milk or not, discontinue either drug or breast feeding Elderly: Patients age 65 and older were more likely to fall (experiencing bone and joint injuries), have cardiovascular events, develop respiratory disorders, and

Side Effects

Nausea and vomiting; dyskinesia; dizziness; yawning; drowsiness; transient sedation; postural hypotension; neuropsychiatric disturbances; CNS stimulation; increased salivation and perspiration; eosinophilia; rhinitis; pharyngitis; cough; flushing; taste disturbance; vasovagal syndrome. Less frequently syncope, stomatitis and mouth ulcers.

Drug Interactions

Antipsychotics, CNS dopamine inhibitors, antihypertensives, organic nitrates, entacapone and memantine. Apomorphine is an opiate drug that acts as a potent central dopamine agonist to directly stimulate the CTZ. In animals it can be used as emetic drug. It can also be applied directly to conjunctival and gingival membranes, using the tablet formulation, which can easily be removed once emesis is initiated.