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Title: | Pharmacological management of Parkinson's disease. | Authors: | Iansek R. | Institution: | (Iansek) Geriatric Research Unit, Geriatric Neurology Service, Kingston Centre, Cheltenham, Vic., Australia (Iansek) Geriatric Research Unit, Kingston Centre, Warrigal Road, Cheltenham, Vic. 3192, Australia | Issue Date: | 19-Oct-2012 | Copyright year: | 2004 | Publisher: | Society of Hospital Pharmacists of Australia (P.O.Box 1774, Collingwood VIC 3066, Australia) | Place of publication: | Australia | Publication information: | Journal of Pharmacy Practice and Research. 34 (3) (pp 229-232), 2004. Date of Publication: September 2004. | Abstract: | Parkinson's disease is an incurable neurodegenerative disease of the elderly. Although symptoms can be ameliorated by drugs, optimum management requires a multidisciplinary approach. Pharmacotherapy is usually initiated with levodopa using gradual dosage titration. Initial therapy with dopamine agonists such as cabergoline can be considered in younger patients. Cabergoline can also be used to reduce levodopa dosage in patients who develop dyskinesia. End-of-dose effects may require more frequent levodopa administration and the addition of a catechol-O-methyl transferase inhibitor such as entacapone. In mid-stage disease a degree of dyskinesia may be accepted in order to maintain movement capacity. Cabergoline can also be used for levodopa sparing. In advanced disease, fluctuations between on and off states become rapid and disabling. Levodopa dosage can be further refined with a liquid formulation and apomorphine may be used to overcome sudden off periods. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1002/jppr2004343229 | ISSN: | 1445-937X | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/32509 | Type: | Review | Subjects: | extrapyramidal symptom/si [Side Effect] hallucination/si [Side Effect] human hypomania/si [Side Effect] liver dysfunction/si [Side Effect] nausea/si [Side Effect] orthostatic hypotension/dt [Drug Therapy] orthostatic hypotension/si [Side Effect] *Parkinson disease/di [Diagnosis] *Parkinson disease/dt [Drug Therapy] *Parkinson disease/et [Etiology] psychosis/dt [Drug Therapy] psychosis/si [Side Effect] rash/si [Side Effect] review sedation amantadine/ae [Adverse Drug Reaction] amantadine/dt [Drug Therapy] bromocriptine/ae [Adverse Drug Reaction] bromocriptine/do [Drug Dose] bromocriptine/dt [Drug Therapy] cabergoline/ae [Adverse Drug Reaction] cabergoline/do [Drug Dose] cabergoline/dt [Drug Therapy] cabergoline/pk [Pharmacokinetics] catechol methyltransferase inhibitor/ae [Adverse Drug Reaction] catechol methyltransferase inhibitor/dt [Drug Therapy] chlorpromazine/ae [Adverse Drug Reaction] chlorpromazine/dt [Drug Therapy] decarboxylase inhibitor/ae [Adverse Drug Reaction] decarboxylase inhibitor/dt [Drug Therapy] entacapone/ae [Adverse Drug Reaction] entacapone/dt [Drug Therapy] ephedrine/dt [Drug Therapy] levodopa/ae [Adverse Drug Reaction] levodopa/do [Drug Dose] levodopa/dt [Drug Therapy] midodrine/dt [Drug Therapy] olanzapine/ae [Adverse Drug Reaction] olanzapine/dt [Drug Therapy] pergolide/ae [Adverse Drug Reaction] pergolide/do [Drug Dose] pergolide/dt [Drug Therapy] pimozide/ae [Adverse Drug Reaction] pimozide/dt [Drug Therapy] quetiapine/ae [Adverse Drug Reaction] quetiapine/dt [Drug Therapy] risperidone/dt [Drug Therapy] thioridazine/ae [Adverse Drug Reaction] thioridazine/dt [Drug Therapy] risperidone/ae [Adverse Drug Reaction] anxiety disorder/si [Side Effect] cardiovascular disease/si [Side Effect] clinical feature confusion/si [Side Effect] disease course disease exacerbation/si [Side Effect] drug bioavailability drug choice drug efficacy drug half life drug safety dyskinesia/dt [Drug Therapy] dyskinesia/si [Side Effect] dyskinesia / drug therapy / side effect extrapyramidal symptom / side effect hallucination / side effect human hypomania / side effect liver dysfunction / side effect nausea / side effect orthostatic hypotension / drug therapy / side effect *Parkinson disease / *diagnosis / *drug therapy / *etiology psychosis / drug therapy / side effect confusion / side effect review sedation clinical feature cardiovascular disease / side effect anxiety disorder / side effect rash / side effect disease course disease exacerbation / side effect drug bioavailability drug choice drug efficacy drug half life drug safety |
Type of Clinical Study or Trial: | Review article (e.g. literature review, narrative review) |
Appears in Collections: | Articles |
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