Parkinson's Disease

This is a disease with an unknown cause that is characterized by a resting tremor, rigidity, slow movements and gait disturbance. These symptoms are the result of an imbalance between dopaminergic and cholinergic activity in the substantia nigra. Approximately 1 million people suffer for Parkinson's Disease.

Treatment Goals:

Stages of Parkinson's Disease

  Early. This stage is characterized by tremor, changes in handwriting, slow movements, and drooling. Some patients require medications with mild antiparkisonian action. This stage can last months to 2 to 3 years.

  Nonfluctuating. When mild medications can no longer control the symptoms, patients are considered to have entered the nonfluctuating stage. Adding Sinemet almost always becomes necessary.

  Fluctuating. When motor fluctuations (marked inconsistencies in control of symptoms) occur, patients are considered to have entered the fluctuating stage. There are two types of motor fluctuations. Wearing off effect: occurs when the duration of aciton of a levodopa preparation lasts for decreasing periods of time. On/Off Phenomenon: occurs when patient fluctuate suddenly from no therapeutic benefit to complete improvement of symptoms.

 Appearance of Parkinsonism

Medications with Parkinsonian Symptoms:

Compazine

Cardizem

Thorazine

Isoptin

Haldol

Capoten

Reglan

Dilantin

 

Self Assessment:

What is the rationale for the combination of Carbidopa and Levadopa in the treatment of parkinson's disease?

Email answers to: frizzell@lasalle.edu

 

Ó JVolpe & JFrizzell 1999