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Parkinson's disease
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GoT of PD Tx
minimize s/s
maintain QoL
prolong survival
Cardinal S/S of PD
coarse tremor
cogwheel rigidity (jerky resistance to passive movement)
bradykinesia
postural changes (usually later)
Non-motor complications of PD and management
S/E of DA Tx
(LDOPA/carbidopa 100mg/25mg TID)
confusion
hallucination
N/V
orthostatic hypotension
red urine
Motor fluctuations with long-term Tx (3-5years)
1. wearing-off effect:
breakthrough s/s near the end of dose interval
2. peak dose dyskinesia:
involuntary movements after dose
3. on-off phenomenon:
random breakthrough s/s (not related to dose timing)
Management of LDOPA motor complications
Strategies to delay LDOPA Tx
1. selegiline (selective irreversible MAO-B inhibitor):
delays need for LDOPA, doesn't increase mortality
2. rasagiline (irreversible MAO-B>>MAO-A) inhibitor:
improves s/s and slow progression
3. DA agonist:
a. ropinirole:
decreased dyskinesia complications when given as initial Tx
b. pramipexole:
decreased dyskinesia complications when given as initial Tx
S/E of selegiline/rassagiline
hallucinations
insomnia
somnolence
parethesia
N/V
edema
S/E of DA agonist (esp. pramipexole)
more hallucinations
more somnolence
more edema
Author
timothy.pdlt
ID
212364
Card Set
Parkinson's disease
Description
therapeutics, side-effects, drug interaction
Updated
4/9/2013, 9:12:01 AM
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