A 45-year-old lady presents with complaints of a progressive increase in the size of hands and feet and shoe size for past 5 years. The family members have noticed a change in her facial appearance in the form of coarsening of features and her voice has become sonorous. She also has complaints of frequent headaches for past 1 year. She complains of amenorrhea for past 5 years. She also has complaints of joint pains for past 3 years which have become more severe for the past 3 months. She is hypertensive for past 1 year and complaints of grade 2 dyspnea on exertion and her hypertension is controlled on 10 mg of cilnidipine and 40 mg of telmisartan. She is not a known diabetic and has checked her random sugars 1 week back which was normal. She is not on any other medications presently (Fig. 1.1).
What options of dopamine agonists are available?
They may be considered as first line in patients who have financial constraints. The commonly used dopamine agonist is cabergoline. Dopamine agonists may be considered particularly in patients with mild biochemical activity, such as in the setting of modestly elevated serum IGF-I levels in the absence or concomitant presence of somatostatin analog (SSA) therapy.
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