Scribd Logo
Upload

Welcome to Scribd!

  • 3 views

    Treatment of PD #Cocci

    Uploaded by

    thaalnoonalqhatani24

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Treatment of PD #Cocci

    Uploaded by

    thaalnoonalqhatani24
    3 views1 page

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    3 views1 page

    Treatment of PD #Cocci

    Uploaded by

    thaalnoonalqhatani24

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    The most effective & widely used ttt for

    motor features of PD

    To #extracerebral decarboxylation of L-dopa

    One tab = 250 mg L-dopa +25 mg carbidopa

    ⬆Dopamine ⬇Acetycholine
    Sinemet L-dopa +carbi-dopa. Dose
    ⬆
    Start 1 tab daily dose by 1/2 tab every 3 days
    Levodopa till case improves

    Best prescriped for rigidity & bradykinesia

    Nausea, Vomiting, Anorexia

    In 50% of pt after 6 years of therapy


    Motor complications
    (honeymoon period)
    SE
    Medical After long ttt with L-dopa

    Signs of parkinsonism (under ttt)


    On & off phenomenon alternating with
    signs of chorea (over ttt)

    ⬇Dose of L-dopa
    &Give other drugs (dopamine agonists

    Dopamine agonists Anticholinergics Amantadine MAO-B inhibitors COMT inhibitors

    🔸Cabergoline 🔸Ropinirole 🔸Benztropine 🔸Sili-giline


    🔸pramipexole 🔸rotigotine 🔸orphenadrine 🔸rasa-giline
    Entacapone (peripheral)
    🔸trihexphenidyl
    Members
    Tolcapone (central)

    ⬆Amount of L-dopa
    ⬆
    Act directly on post-synaptic Antiviral
    Mechanism Monoamine Oxidase B inhibitors
    dopamine receptor dopamine availability reaching CNS

    ⚫Monotherapy in early dis ⚫Previously In early PD


    ⚫now management of
    Only In Young pt with to Delay use of L-dopa
    ⚫adjunct to L-dopa (⬇L-dopa dose)
    Use (in younger pt to Delay use of L-dopa) Adjunct therapy to L-dopa For end-of-dose deteriorants
    Severe tremors & dystonia
    drug-related dyskinesia

    With each dose of Levodopa

    Dose
    L-dopa +carbidopa +entacapone
    =Stalevo

    🔴Closed angle glaucoma


    🔴congnitive impairment 🔴Confusion
    🔴Confusion 🔴hallucination 🔴Confusion
    Treatment of PD 🔴Dry mouth 🔴Insomnia (2nd dose at mid day) 🔴hallucination
    🔴Urine retention 🔴livedo-reticularis 🔴Insomnia (2nd dose at mid day)
    SE

    🔴Nausea 🔴ankle edema


    #cocci 🔴major drawback esp elderly

    ⬇
    ⚫
    Improve motor symptoms SE of dopamine
    best in pt whose motor symptoms
    predominate

    Of Thalamus, subthalalmus or globus pallidus

    Treat most motor symptoms


    Deep Brain Stimulation
    💙NO destruction of Brain tissue
    💙reversible
    💙bilateral procedure can be performed
    without ⬆in adverse event
    The surgical procedure of choice
    Surgery
    💙can be Adjusted as dis progress or adverse event occur
    By external pump

    Intestinal infusion of L-dopa (Duodopa) To better maintain L-dopa Benefit throughout the day

    ⬇Dyskinesia
    Thalamotomy & pallidotomy

    Neuromodulation technique Transcranial magnetic stimulation The most prevalent

    Pharmacogenetics

    Future therapy Gene modification therapy

    Stemcell therapy

    Neural transplantation

    You might also like