Question

A female patient with a negative urine pregnancy test presents to you with galactorrhea. An MRI was done which revealed a large pituitary tumor. If the patient is not willing for surgery, which of the following is the best drug for treatment?

• A. Bromocriptine
• B. Promethazine
• C. Octreotide
• D. Clozapine

Answer 1

The Correct Option is A

The scenario involves a female patient experiencing galactorrhea, which is often caused by a prolactin-secreting pituitary adenoma, also known as a prolactinoma. The patient is not willing to undergo surgery, therefore, medical management is the preferred treatment approach.

The most effective drug for managing a prolactinoma is a dopamine agonist. Dopamine agonists work by reducing prolactin levels, shrinking the tumor size, and alleviating symptoms such as galactorrhea.

Among the options provided, Bromocriptine is a dopamine agonist. It effectively inhibits prolactin secretion by stimulating dopamine receptors, which in turn lowers prolactin levels and alleviates symptoms associated with a prolactinoma.

Promethazine is an antihistamine and has no effect on prolactin levels. Octreotide is used for growth hormone or other hormone-secreting tumors but not primarily for prolactinomas. Clozapine is an antipsychotic and does not address prolactin issues.

Therefore, for a patient with a large pituitary tumor unwilling to have surgery, Bromocriptine is the best therapeutic choice to manage prolactin levels and treat galactorrhea.