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