PRL

LHRH

GHRH PIF CRH TRH SRIH

ADH

FSH-LH

PRL

TSH
ACTH

OXYT

20

PRL

Stress

TRH,

CCK,
GABA,

DA
(-)

dopamine

prolactin

H Da PRL
PRL gene transcription, ,

Gudelsky GA. Tuberoinfundibular dopamine neurons and the regulation of prolactin secretion. Psychoneuroendocrinology
1997; 26: 41-54 1981; 6: 3-16

 PRL Rec

DA
+

PRL

PRL initiate and maintain milk secretion by the mammary glands

Oxytocin, causes milk ejection

()

(DA )

&

LHRH

GHRH PIF CRH TRH SRIH

ADH

FSH-LH
GH

TSH
ACTH

PRL

OXYT

D2 receptor antagonist effects of antipsychotic drugs

antipsychotic drugs
Block of D2 receptors activity
striatum

antipsychotic
efficacy

EPS
Parkinson

pituitary
lactotroph cells

D2 receptors

mesolimbic
mesocortical areas

HyperPRL

Virtually all antipsychotic drugs have the capacity to block D2 receptors



Bromocriptine BRC, D2 (1/2=2h)
Starting dose 1.25 mg (half a tablet) at bedtime for the 1st week, then up to 2.5 - 5 mg twice a day

Quinagolide D2 (1/2=17h)
second line treatment more potent then bromocriptine. Starting dose 25 g/day,
then up to 150-300 g/day

Cabergoline D2 (1/2=60h)
First line treatment, longer acting with fewer side effects 0.25-1.5 mg two times/week

DA
Dopamine
agonists

Bromocriptine
Ergot
(Parlodel)

2.5-10
mg/day

7.5 mg/

Lisuride
(Dopergine)

Ergot

0.1-0.2
mg/day

0.1 mg/

Quinagolide
(Norprolac)

Ergot

25-300
g/day

75 g/

Ergot

0.25-1
1 mg/
mg/TWW

Cabergoline
(Dostinex)

NB: Parlodel GH in healthy and it in acromegalics


:
-

-,


Herring Bodies
Neurophysin-I
(oxytocin)

Neurophysin-ii
(ADH)

AVP

.

Osmolality

.. 2 V2 Rec

V1 Rec

High Osmolality

Low ECF Volume

Osmoreceptors

Low Pressure
Receptors

ADH
Pain

Nausea
Vomiting

Surgical
Stress

Emotions

Standing

AITIA A.

( C, )

( , )

AVP

( )

..
( V2 )
: ( 8/Lysine ) IN
(DDAVP): ( Cys/1)
IV, SC IN ( 2 / .)
DDVAP T1/2 75m. ( AVP=10mn ) x 3000 . V2

AVP ( 8 L-arginine ) SC,IM,IN

 AVP

(, /, ,
o , )

()

erlipressin ( V1 )
:
( U S A )


:

&


&

}

}
( + 2 =>
=> =

s
PRL initiate and maintain milk secretion by the mammary glands
Oxytocin, causes milk ejection

- ( v )
-
. :

( )