Parkinson's Disease Types of Common Drug Treatments Management: - Dr. Guruprasad Hosurkar скачать в хорошем качестве

Parkinson's Disease Types of Common Drug Treatments Management: - Dr. Guruprasad Hosurkar

Parkinson’s disease can be effective treated with medication. There are different classes of drugs used in Parkinson’s disease starting from anticholinergics. The typical anticholinergic drugs like trihexiphenidyl, benzotropine hydrochloride can be used in mitigating the tremors in Parkinson’s disease but these are drugs to be carefully used, they have their own set of side hefts like dryness of mouth, urinary retention. In elderly people it can cause behavioural changes, cognitive problems and all. So we usually use this in very specific indications like young inset Parkinson’s disease , in the age of 40 or 50 where the problems with cognition will not be much affected. So use this in medications who have predominantly tremor in Parkinson’s disease and younger people. Another group of drug is amantadine, is a mild Parkinson’s effects. So we can combine it with other group of drugs in Parkinson’s disease. But specific indication for amantadine is when they develop drug induced dyskinesias, when they develop levodopa induced dyskinesias, amantidine is used. Other group of drugs used in Parkinson’s disease is dopa agonist. We have ergot alkaloids and non-ergot alkaloids with dopa agonists. We have medications like ropinirole, pramipexol, perebidil, cabergolin, so many drugs used as compared to levodopa which is the gold standard in Parkinson’s disease, this has less of anti Parkinson’s effect, but nevertheless, they are very effective especially when they are used very early on in the disease, they give relief to most of the symptoms in Parkinson’s disease, be it tremors, bradykinesia, rigidity, they have efct on mosyt of the features of Parkinson’s disease. The dose is also quite varying, we can start using form low dose to high dose, but when we talk about dopa agonists, they have specific side effects, talking about pramipexol and ropinirole, they can cause day time somnolence and swelling of the feet Later on in the disease also it can cause drug induced hallucinations in Parkinson’s disease. These can cause psychosis. So we need to keep a watch on these side effects. But even after 40 years after the introduction of levodopa, to remains the gold standard for treatment of Parkinson’s disease. It almost reverses the symptoms of Parkinson’s disease like tremors, bradykinesia and gives you significant improvement in the quality of life in Parkinson’s disease. Over the course of the disease levodopa requirement goes up, we need to optimise the dosing. We combine it sometimes with carbidopa and sometimes COBT inhibitors to increase the effectiveness of levodopa over the time, it can lead to side effects like motor fluctuations, hallucinations, dyskinetic. But there are ways to fine tune the dose of these medications to give effective response to Parkinson’s disease. Secondary or atypical Parkinson’s disease can also respond to these drugs. It ca be less as compared to other typical Parkinson’s disease, but nevertheless they do respond atleast respond briefly or around 2 to 30% response in atypical Parkinson’s disease.