Parkinson's disease : Parkinson's disease (PD also known as idiopathic or primary Parkinsonism, hypokinetic rigid syndrome/HRS, or paralysis agitans) is a degenerative disorder of the central nervous system. The motor symptoms of Parkinson's disease result from the death of dopamine-generating cells in the substantia nigra, a region of the midbrain; the cause of this cell death is unknown. Tremor, rigidity, bradykinesia, and postural instability are the cardinal features of Parkinsonism and may be present in any combination. There may also be a mild decline in intellectual function. The tremor of about four to six cycles per second is most conspicuous at rest, is enhanced by emotional stress, and is often less severe during voluntary activity. Although it may ultimately be present in all limbs, the tremor is commonly confined to one limb or to the limbs on one side for months or years before it becomes more generalized.
Commonly used drugs in Parkinson disease include Levodopa-Carbidopa combination, Anticholinergics (orphenadrine , procyclidine ,trihexyphenidyl ), Dopamine Agonists( Bromocriptine, Carbergoline, Ropinirole, Pramipexole and Lisuride.), COMT inhibitors (entacapone ,Tolcapone) and MAO-B inhibitors ( rasagiline,selegiline)
Hyperprolactinaemia : Hyperprolactinaemia is defined as an elevation of prolactin level above 25ng/ml in women of childbearing age and above 20ng/ml in men and post-menopausal women. It occurs in the Pituitary gland which is located at the base of the hypothalamus. Hyperprolactinaemia is a raised level of prolactin in the blood. This hormone stimulates breast epithelial cell proliferation and induces milk production. The primary action of prolactin is to stimulate lactation. However, excessive production of prolactin leads to infertility and gonadal dysfunction. Prolactin suppresses gonadotrophin-releasing hormone (GnRH), resulting in suppression of ovulation in females and reduced testosterone levels and hypogonadism in males.
Medication
• Most patients will be treated with a dopamine agonist. Dopamine agonists suppress prolactin in most patients, normalise gonadal function and also stop galactorrhoea. Cabergoline and bromo-criptine are both ergot-based dopamine receptor agonists. Cabergoline is the first-line treatment for prolactinomas as it has greater efficacy in suppressing prolactin secretion.