{"id":1488,"date":"2021-11-29T21:45:18","date_gmt":"2021-11-29T20:45:18","guid":{"rendered":"https:\/\/sfrms-app.fr\/?p=1488"},"modified":"2022-10-17T09:01:11","modified_gmt":"2022-10-17T07:01:11","slug":"agonistes-dopaminergiques","status":"publish","type":"post","link":"https:\/\/sfrms-app.fr\/index.php\/2021\/11\/29\/agonistes-dopaminergiques\/","title":{"rendered":"Agonistes dopaminergiques"},"content":{"rendered":"<h2><span style=\"font-size: 14pt;\">Mode d&rsquo;action<\/span><\/h2>\n<ul>\n<li>Les agonistes dopaminergiques non ergot&eacute;s stimulent les r&eacute;cepteurs dopaminergiques. Le mode d&rsquo;action exact de ces agonistes dopaminergiques dans le <a href=\"https:\/\/sfrms-app.fr\/index.php\/glossary\/syndrome\/\" title=\"Glossary: Syndrome\"  class=\"glossaryLink\">syndrome<\/a> des jambes sans repos est mal connu.<\/li>\n<li>Ce sont :\n<ul>\n<li>Le Pramipexole (SIFROL&reg;, comprim&eacute;s 0,18 mg),<\/li>\n<li>La Rotigotine (NEUPRO&reg;, dispositifs transdermiques 2,4 mg\/24 h),<\/li>\n<li>Le Ropinirole (ADARTREL&reg;, comprim&eacute;s 0,25 mg 0,5 mg 1 mg 2 mg).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2><span style=\"font-size: 14pt;\">Indications<\/span><\/h2>\n<p>Les agonistes dopaminergiques ont une AMM dans les formes mod&eacute;r&eacute;es &agrave; tr&egrave;s s&eacute;v&egrave;res du syndrome des jambes sans repos (cf. Fiche : <a href=\"https:\/\/sfrms-app.fr\/index.php\/2021\/12\/27\/syndrome-des-jambes-sans-repos\/\"><strong>Syndrome des jambes sans repos<\/strong><\/a>).<br>Les recommandations les pr&eacute;conisent principalement pour les formes tr&egrave;s s&eacute;v&egrave;res.<\/p>\n<h2><span style=\"font-size: 14pt;\">Contre-indications<\/span><\/h2>\n<ul>\n<li>Insuffisance r&eacute;nale s&eacute;v&egrave;re (sauf pour la Rotigotine).<\/li>\n<li>Insuffisance h&eacute;patique s&eacute;v&egrave;re (uniquement pour le Ropinirole).<\/li>\n<li>Penser &agrave; enlever le dispositif transdermique de Rotigotine pour l&rsquo;IRM.<\/li>\n<\/ul>\n<h2><span style=\"font-size: 14pt;\">Bilan pr&eacute; th&eacute;rapeutique<\/span><\/h2>\n<p>Rechercher des troubles addictifs.<\/p>\n<h2><span style=\"font-size: 14pt;\">R&egrave;gles de prescription<\/span><\/h2>\n<ul>\n<li>Pour le Ropinirole : prescription initiale r&eacute;serv&eacute;e aux neurologues et aux m&eacute;decins<br>exer&ccedil;ant dans un centre du <a href=\"https:\/\/sfrms-app.fr\/index.php\/glossary\/sommeil\/\" title=\"Glossary: Sommeil\"  class=\"glossaryLink\">sommeil<\/a>, sur ordonnance classique.<\/li>\n<li>Aucun remboursement actuel des agonistes <a href=\"https:\/\/sfrms-app.fr\/index.php\/glossary\/dopaminergique\/\" title=\"Glossary: Dopaminergique\" class=\"glossaryLink\">dopaminergique<\/a> dans l&rsquo;indication de SJSR.<\/li>\n<li>Prise 1 h avant l&rsquo;heure de d&eacute;but des sympt&ocirc;mes.<\/li>\n<li>Doses :<\/li>\n<li style=\"list-style-type: none;\">&nbsp;<\/li>\n<\/ul>\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"424\" height=\"567\" src=\"https:\/\/sfrms-app.fr\/wp-content\/uploads\/2021\/11\/Capture-52.png\" alt=\"\" class=\"wp-image-1559\" srcset=\"https:\/\/sfrms-app.fr\/wp-content\/uploads\/2021\/11\/Capture-52.png 424w, https:\/\/sfrms-app.fr\/wp-content\/uploads\/2021\/11\/Capture-52-224x300.png 224w\" sizes=\"auto, (max-width: 424px) 100vw, 424px\"\/><\/figure>\n<\/div>\n\n\n<ul class=\"wp-block-list\"><li><strong>Pramipexole<\/strong>: la dose initiale recommand&eacute;e est de 0,09 mg (1\/2 cp &agrave; 0,18 mg) en 1 prise par jour. Augmentation possible tous les 7 jours jusqu&rsquo;&agrave; la dose maximale de 0,54 mg (3 cp &agrave; 0,18 mg).<\/li><li><strong>Rotigotine<\/strong>: la dose initiale est de 1 mg\/24 h (voie transdermique). Augmentation possible de 1 mg\/24 h chaque semaine jusqu&rsquo;&agrave; la dose maximale de 3 mg\/24 h.<\/li><li><strong>Ropinirole<\/strong>: la dose initiale est de 0,25 mg. Augmentation possible jusqu&rsquo;&agrave; jusqu&rsquo;&agrave; la dose maximale de 2 mg\/24 h.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Surveillance des effets ind&eacute;sirables<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>EI fr&eacute;quents<ul><li>Naus&eacute;es, c&eacute;phal&eacute;es, <a href=\"https:\/\/sfrms-app.fr\/index.php\/glossary\/somnolence\/\" title=\"Glossary: Somnolence\"  class=\"glossaryLink\">somnolence<\/a>, hypotension orthostatique, hallucinations.<\/li><\/ul><\/li><li>EI s&eacute;v&egrave;res<ul><li><strong>Troubles du contr&ocirc;le des impulsions<\/strong> (informer syst&eacute;matiquement les patients, aspect m&eacute;dico-l&eacute;gal) : trouble de r&eacute;gulation des <a href=\"https:\/\/sfrms-app.fr\/index.php\/glossary\/comportements\/\" title=\"Glossary: Comportements\" class=\"glossaryLink\">comportements<\/a> de jeux, d&rsquo;achats, sexuels et de prise alimentaire,<\/li><li><strong><a href=\"https:\/\/sfrms-app.fr\/index.php\/glossary\/syndrome\/\" title=\"Glossary: Syndrome\"  class=\"glossaryLink\">Syndrome<\/a> d&rsquo;augmentation<\/strong> (aggravation paradoxale du SJSR) : survenue des sympt&ocirc;mes plus pr&eacute;cocement durant la journ&eacute;e et\/ou augmentation de leur <a href=\"https:\/\/sfrms-app.fr\/index.php\/glossary\/severite\/\" title=\"Glossary: S&eacute;v&eacute;rit&eacute;\" class=\"glossaryLink\">s&eacute;v&eacute;rit&eacute;<\/a> et\/ou atteinte d&rsquo;autres parties du corps pendant la prise du traitement,<\/li><li><strong>Effet ind&eacute;sirable de la Rotigotine<\/strong>: r&eacute;actions s&eacute;v&egrave;res d&rsquo;intol&eacute;rance cutan&eacute;e au site d&rsquo;application.<\/li><\/ul><\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Suivi d&rsquo;efficacit&eacute;<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>Efficacit&eacute; clinique : plaintes de syndrome de jambe de repos (cf. Fiche : <a href=\"https:\/\/sfrms-app.fr\/index.php\/2021\/11\/28\/echelle-de-depistage-et-de-severite-du-syndrome-des-jambes-sans-repos\/\"><strong>&Eacute;chelle de s&eacute;v&eacute;rit&eacute; du SJSR<\/strong><\/a>).<\/li><li>Un suivi doit &ecirc;tre effectu&eacute; au long cours par un m&eacute;decin du sommeil, car il s&rsquo;agit de ne pas confondre une diminution d&rsquo;efficacit&eacute; d&rsquo;un syndrome d&rsquo;augmentation.<\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Mode d&rsquo;action Les agonistes dopaminergiques non ergot&eacute;s stimulent les r&eacute;cepteurs dopaminergiques. Le mode d&rsquo;action exact de ces agonistes dopaminergiques dans le syndrome des jambes sans repos est mal connu. Ce sont : Le Pramipexole (SIFROL&reg;, comprim&eacute;s 0,18 mg), La Rotigotine [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":4061,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12,32],"tags":[],"class_list":["post-1488","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-traitement","category-traitements-des-troubles-moteurs-du-sommeil"],"featured_image_src":"https:\/\/sfrms-app.fr\/wp-content\/uploads\/2021\/11\/UTwTq5an_normal.png","blog_images":{"medium":"https:\/\/sfrms-app.fr\/wp-content\/uploads\/2021\/11\/UTwTq5an_normal.png","large":"https:\/\/sfrms-app.fr\/wp-content\/uploads\/2021\/11\/UTwTq5an_normal.png"},"_links":{"self":[{"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/posts\/1488","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/comments?post=1488"}],"version-history":[{"count":7,"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/posts\/1488\/revisions"}],"predecessor-version":[{"id":4083,"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/posts\/1488\/revisions\/4083"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/media\/4061"}],"wp:attachment":[{"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/media?parent=1488"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/categories?post=1488"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/tags?post=1488"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}