Clinical Psychopharmacology
|
|
- Rosamond Morgan
- 8 years ago
- Views:
Transcription
1 Clinical Psychopharmacology Antiparkinsonian drugs Department of Pharmacy, GGZ WNB Chair on Pharmacotherapy in Psychiatric Patients/Anton Loonen
2 May Basal ganglia diseases Parkinson s disease and other forms of parkinsonism Multisystem Atrophy (MSA) MSA-p type (Parkinsonism) MSA-c type (Cerebellar) Many autonomic signs and symptoms Drug-unresponsive Parkinson s disease Chorea Chorea minor (Sydenham) Chorea major (Huntington) Restless legs syndrome (RLS) & Periodic Limb Movement Disorder (PLMD)
3 May Clinical presentations of Parkinson s disease Slowness of movement Bradykinesia Slow monotonous speach Reduced swallowing (dribbling) Bradyphrenia Rigidity Postural instability Tremors Resting tremor (pill-rolling tremor) Postural tremor (increased)
4 Neuropathology of Parkinson s disease Neurodegeneration Dopaminergic neurons SNc (area A9) > 50-60%. Motor symptoms Adrenergic neurons Autonomic nuclei (NTS) Hypotension Serotonergic neurons Raphe nuclei Mood and anxiety symptoms Cholinergic neurons Nucleus basalis [Meynert] Dementia
5 May Regulation of motor activity Cerebral cortex Pyramidal tract activity (glu) Spasms Cerebellar adjustment Mutual adjustment of movements (GABA) Ataxia Extrapyramidal system Mutual adjustment of muscle agonists/antagonists (Glu/GABA) Parkinsonism
6 May Schedule extrapyramidal regulation Cerebral cortex à Spinal cord (MPG) à muscle Striatum (MSN) à thalamus Spinal cord à Brain stem à cerebellum Thalamus Thalamus à Cortex
7 May Inhibition/augmentation of pyramidal activity Pyramidal pathway Activate MPG in spinal cord Direct EP pathway Carry excitatory DRD1 Augment cortical activity DA increases cortical activity Indirect EP pathway Carry inhibitory DRD2 Inhibit cortical activity DA increases cortical activity
8 May Stratal medium sized GABA-ergic neurons Glutamatergic neurons Corticostriatal synapses Thalamostriatal synapses Cholinergic interneurons Medium spiny neurons Glutamatergic terminals Dopaminergic neurons Medium spiny neurons Serotonergic neurons Medium spiny neurons Dopaminergic terminals GABA-ergic interneurons
9 May Neurobiology of Parkinson Degeneration of DA neurons Oxidative metabolism of DA Free radicals and H 2 O 2 Oxidative stress Genetics of Parkinson s disease Familial Parkinson s disease Large kindreds with PD Mitochondrial inheritance Susceptibility genes
10 Treatment of Parkinson s disease Increase dopaminergic influence Levodopa MAO and COMT inhibitors Dopamine-receptor agonists Adjust sensitivity of MSN Inhibit cholinergic interneurons (anti-muscarinic) Inhibit serotonergic influence (5-HT 2 antagonist) Adapt glutamatergic influence (NMDA antagonists)
11 Levodopa Levodopa alone (obsolete) Levodopa with decarboxylase inhibitor Benserazide Immediate release capsules, tablets Slow release capsules (beginning wearing off) Carbidopa Immediate release tablets Slow release tablets Intestinal gel Carbidopa and entacapon (COMT-inhibitor) Immediate release tablets (less wearing off)
12 Enzyme inhibitors MAO inhibitors Selegeline and rasagiline Selective for MAO-B Blocks oxidative metabolism COMT inhibitors Entacapone and tolcapon (hepatotoxic) Also increases penetration into brain
13 Amantadine Complex mechanism of action N-methyl-D-aspartate (NMDA) antagonism Dopamine reuptake inhibition Dopamine release Anticholinergic activity Indications for use Starting PD Drug-induced parkinsonism Peak-dose dyskinesia
14 Dopamine D2 receptor agonists Halflife (hrs) Ergot-structure Bioavailability (%) Remarks Bromocriptine Weak D1-antagonist Pergolide Weak D1-agonist Pramipexol Preferential D3 Ropinerol 6-50 Preferential D3 Rotigotine transdermal Apomorfine subcuteneously Weak D1-agonist Potent D1-agonist
15 Complications of treatment with levodopa Predictable off phases: wearing off Gradual decrease off effect End of dose bradykinesia Dyskinesia during on phase Abnormal involuntary movements Peak dose hyperkinesia Unpredictable on/off phases Freezing switching suddenly to hyperkinesia Slow decrease of effectivity due to disease progression
16 Drug treatment of Parkinson s disease Phase V Phase IV + amandadine Phase III SR levodopa (+) DRD2 agonist sc apomorphine Intra-intestinal gel Phase II IR levodopa Wearing off Phase I MAO inhibitor Amantadine (DRD2 agonist) Levodopa-induced dyskinesia Refractory hypokinesia Training activities of daily living (ADL) support nursing home
17 New developments Etilevidopam and melevodopa Oromucosal tablets of selegiline Transdermal patches of lisuride Racemide (NMDA antagonist) Adenosine A2 antagonists
18 Extrapiramidal side effects of antipsychotics Acute: akathisia, dystonia, parkinsonism Tardive: dyskinesia, dystonia
19 Akathisia Adversity to standing or sitting still; increased frequency of regular movements; primarily, but not exclusively affects the legs. Treatment with b-blocking drugs, sedatives and anticholinergics
20 Parkinsonism Akinetic syndrome & akinetic hypertonic syndrome Reduction and/or slowing of all movement; equable plastic resistance to passive movement; hypersalivation and shiny skin; slow tremors that appear during rest and decrease during activity Anticholinergics
21 Dystonia Slow, irregular, continuous contractions (spasms); contractions result in slow movements or abnormal postures; contractions continue for more than 2 seconds Acute: anticholinergics Tardive: clozapine, anticholinergics
22 Dyskinesia BLM-syndrome, peripheral syndrome & respiratory syndrome Rapid, irregular, repetitive contractions; motionless intervals between contractions; increases during activity and anxiety Clozapine
23 Other common movement disorders Tremor Postural tremor: beta-blocking drug Nocturnal movement disorders Myoclonus: clonazepam Restless legs syndrome (RLS)/Periodic Limb Movement Disorder (PLMD): DRD2 agonist
24 Thank you for your attention
Neuropharmacology I Parkinson s Disease and Movement Disorders
Harvard-MIT Division of Health Sciences and Technology HST.151: Principles of Pharmocology Instructor: Dr. David Standaert Standaert 1 Neuropharmacology I Parkinson s Disease and Movement Disorders What
More informationAnti-Parkinsonism Drugs
Anti-Parkinsonism Drugs Pharma Team 429 Fahad Alrumaih Ibrahim Alshiddi Sultan Alsalem Ismail Raslan Suhail Asiri Parkinsonism - Could be: primary [idiopathic] or secondary [viral infection or drug induced
More informationDementia & Movement Disorders
Dementia & Movement Disorders A/Prof Michael Davis Geriatrician ACT Health & GSAHS ANU Medical School Eastern Dementia Network Aged and Dementia Care Symposium Bateman s Bay, 22 October 2010 Types of Dementia
More informationGLOSSARY OF TERMS. This glossary explains the terms and words often used in association with Parkinson s.
Antagonist This glossary explains the terms and words often used in association with Parkinson s. Medications which have a negative effect on particular cells in the body. In Parkinson s dopamine antagonists
More informationChapter 28. Drug Treatment of Parkinson s Disease
Chapter 28 Drug Treatment of Parkinson s Disease 1. Introduction Parkinsonism Tremors hands and head develop involuntary movements when at rest; pin rolling sign (finger and thumb) Muscle rigidity arthritis
More informationManagement of Parkinson s Disease in Primary Care
Management of Parkinson s Disease in Primary Care Dr June Tan National University Hospital System (NUHS) Division of Neurology Senior Consultant Topics: Diagnosing PD Choice of medication in the de novo
More informationMotor Fluctuations in Parkinson s
Motor Fluctuations in Parkinson s What are motor fluctuations? Motor fluctuations are associated with longterm use of levodopa (trade names Sinemet or Madopar, Co-careldopa or Co-beneldopa), and usually
More informationCENTRAL NERVOUS SYSTEM MANAGEMENT OF PARKINSON S DISEASE
MANAGEMENT CENTRAL NERVOUS SYSTEM MANAGEMENT OF PARKINSON S DISEASE Parkinson s Disease is classically determined by the triad or rest tremor (usually starting in one arm) with bradykinesia (slowing of
More informationDoncaster & Bassetlaw Medicines Formulary
Doncaster & Bassetlaw Medicines Formulary Section 4.9: Drugs Used in Parkinsonism and related Disorders Co-Beneldopa 12.5/50, 25/100 and 50/200 (Madopar) Capsules Co-Beneldopa 12.5/50 and 25/100 Dispersible
More informationPARKINSON S DISEASE AND PARKINSONISM. Dr Phil Wood Geriatrician, Waitemata DHB Clinical Unit Leader, Waikato DHB
PARKINSON S DISEASE AND PARKINSONISM Dr Phil Wood Geriatrician, Waitemata DHB Clinical Unit Leader, Waikato DHB OUTLINE Covering:- Why this is an important area of Medical and Psychiatric care The variety
More informationParkinson s Disease - A Junior Doctor s Survival Guide
Parkinson s Disease - A Junior Doctor s Survival Guide Professor Richard Walker Consultant Geriatrician Hon. Professor of Ageing & Interna
More informationUnderstanding Parkinson s Disease
Understanding Parkinson s Disease Irene Oh, MD Neurologist, Movement Disorders Specialist The Neurology Center of Southern California, Encinitas & Escondido Introduction PD was first described in 1817
More informationDrug-induced movement
FEATURE Recognizing and managing drug-induced movement disorders Reprint from DUE Quarterly, July 2003 RICHARD CAMICIOLI, MD, Department of Medicine, University of Alberta, Edmonton, AB NOREEN VANDERBURGH,
More informationPharmacology of the Central Nervous System (CNS) Dr. Sabry Attia. November 2006
Pharmacology of the Central Nervous System (CNS) Dr. Sabry Attia November 2006 Neurodegenerative disease Neurodegenerative disease is a condition which affects brain function. They are result from deterioration
More informationHow To Treat Aphasic Depression
Antipsychotic Use in Patients with Parkinson s Disease 단국의대 정신과 이석범 Difficulties in Parkinson's disease Motor symptoms Neuropsychiatric syndromes Severe Disability Cognitive impairment 2 Neuropsychiatric
More informationAcute management of Parkinson s
Acute management of Parkinson s Fife Parkinson s Service 2013 1 Contents 1. Introduction 2. On admission to hospital 3. If Patient has compromised swallow or is nil by mouth 4. Conversion charts if patient
More informationMovement Disorders and Extrapyramidal System. Doç.. Dr. Sibel Ertan
Movement Disorders and Extrapyramidal System Doç.. Dr. Sibel Ertan İ.Ü.. CTF. Nöroloji N ABD. Motor System I. neuron (corticospinal pathway) Extrapyramidal system (basal ganglia) Cerebellum Loops for praxis
More informationParkinson s Disease and Dementia. Dr N Samaniego Consultant Physician and Geriatrician
Parkinson s Disease and Dementia Dr N Samaniego Consultant Physician and Geriatrician Case 68 year old female. Off legs for a few months, O/E no neurological deficit. -Slowing down -Needs help with dressing,
More informationMultiple System Atrophy
Multiple System Atrophy U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service National Institutes of Health Multiple System Atrophy What is multiple system atrophy? Multiple system atrophy
More informationParkinson's s disease - a
Parkinson's Disease Parkinson's s disease - a progressive disorder of the nervous system that affects movement. The most common perception of Parkinson s is the patient having tremors. Hands shaking, inability
More informationMotor dysfunction 2: Spinal cord injury and subcortical motor disorders ANATOMY REVIEW: Basal Ganglia
Motor dysfunction 2: Spinal cord injury and subcortical motor disorders ANATOMY REVIEW: Basal Ganglia A group of subcortical nuclei caudate, putamen, globus pallidus Caudate & Putamen = Neostriatum caudate
More informationMovement Disorders: Diagnosis i and Treatment. Movement Disorders: Classification
Movement Disorders: Diagnosis i and Treatment Lawrence Elmer, MD, PhD Professor Dept. of Neurology University of Toledo College of Medicine Movement Disorders: Review Movement Disorders: Classification
More informationMovement Disorder Emergencies. Anne E. A. Constantino, MD Attending Neurologist Holy Cross Hospital Silver Spring, MD June 28, 2014
Movement Disorder Emergencies Anne E. A. Constantino, MD Attending Neurologist Holy Cross Hospital Silver Spring, MD June 28, 2014 Objectives Provide a working definition of movement disorder emergencies
More informationWelcome to the Medical Risk Webinar: a taster of Assessing and Managing Medical Risk for Insurers courses. 26 April 2013
Welcome to the Medical Risk Webinar: a taster of Assessing and Managing Medical Risk for Insurers courses 26 April 2013 1 Parkinson s Disease & Multiple Sclerosis Dr Nick Niven Jenkins 2 Movement Human
More informationMr James Garrard University of Leicester May 2014
Parkinson s disease exemplifies the art and science of geriatric medicine. Introduction First described by Dr. James Parkinson in the classic essay The Shaking Palsy in 1817 (1), Parkinson s disease is
More informationParkinson s disease. 14 June 2012
Parkinson s disease 14 June 2012 Cardinal sign of parkinsonism As least 2/4 for diagnosis Resting tremor Bradykinesia Rigidity Postural instability Classification Idiopathic Parkinson disease Secondary
More informationThe majority of parkinsonism (approx. 80%) is due to idiopathic PD other causes include drug therapy (Table 1),toxins and trauma.
THE TREATMENT OF PARKINSON S DISEASE SUMMARY Levodopa (L-dopa) administered in conjunction with a dopa decarboxylase inhibitor (DDCI) remains the mainstay of therapy for Parkinson s disease. New drugs
More informationIII./3.1.2. Parkinsonian syndrome (parkinsonism, atypical parkinsonian disorders) in neurodegenerative diseases
III./3.1.2. Parkinsonian syndrome (parkinsonism, atypical parkinsonian disorders) in neurodegenerative diseases III./3.1.2.1. Multiple System Atrophy (MSA) MSA is a sporadic, adult onset degenerative neurological
More informationMeeting Report: XX WFN World Congress on Parkinson s Disease and Related Disorders
Meeting Report: XX WFN World Congress on Parkinson s Disease and Related Disorders Karen Frei, Erik Ch. Wolters Abstract: The twentieth World Congress on Parkinson s Disease and Related Disorders was held
More informationChapter 18 Drugs Used for Psychoses Learning Objectives Identify signs and symptoms of psychotic behavior Describe major indications for the use of
Chapter 18 Drugs Used for Psychoses Learning Objectives Identify signs and symptoms of psychotic behavior Describe major indications for the use of antipsychotic agents Identify common adverse effects
More informationBasal Ganglia. Motor systems
409 systems Basal Ganglia You have just read about the different motorrelated cortical areas. Premotor areas are involved in planning, while MI is involved in execution. What you don t know is that the
More information9/20/2010. Disclaimer. Movement Disorders in Psychiatry. Overview of Key Points: Learning Objectives:
Movement Disorders in Psychiatry Badari Birur,MD PGY4 Psychiatry Resident ETSU James H. Quillen College of Medicine Disclaimer NEITHER THE PUBLISHER NOR THE AUTHORS ASSUME ANY LIABILITY FOR ANY INJURY
More informationWhat is PD? Dr Catherine Dotchin MD MRCP Consultant Geriatrician
What is PD? Dr Catherine Dotchin MD MRCP Consultant Geriatrician Overview of presentation Case history Video example pre and post treatment Historical review PD in the UK Epidemiology and aetiology Making
More informationCerebellum and Basal Ganglia
Cerebellum and Basal Ganglia 1 Contents Cerebellum and Basal Ganglia... 1 Introduction... 3 A brief review of cerebellar anatomy... 4 Basic Circuit... 4 Parallel and climbing fiber input has a very different
More informationPharmacological Management of Parkinson s Disease Robert Iansek
GERIATRIC THERAPEUTICS Editors: Associate Professor Michael Woodward, Director, Aged and Residential Care Services, Dr Margaret Bird, Consultant Geriatrician, Mr Rohan Elliott, Clinical Pharmacist, Austin
More informationParkinson s Disease and Tremors
Parkinson s Disease and Tremors Current Strategies Leah Karliner, MD, MAS Division of General Internal Medicine Disclosures I have no conflicts of interest Parkinsonism neurological syndrome: Bradykinesia:
More informationPersonal Health Record
Personal Health Record Contents Section 1: Personal details (pages 4 6) Within this section you can note all information about you, next of kin, important health information and general medical history.
More informationChapter 20 USE OF DRUGS FOR NEUROLOGICAL DISORDER
Chapter 20 USE OF DRUGS FOR NEUROLOGICAL DISORDER Sapiah S. 1, Mohd. Sufian A. 1, Norsima Nazifah S. 2, Nurul Faezah M.Y. 2, Khutrun Nada Z. 1, Md. Hanip M.R. 1 1. Kuala Lumpur Hospital, Kuala Lumpur,
More informationJournal Club. Parkinsonismo iatrogeno
PROGETTO UNIVA 2013 Journal Club Parkinsonismo iatrogeno Pietro Gareri, MD, PhD Geriatra ASP Catanzaro Lamezia Terme 3 Luglio 2013 Drug-induced parkinsonism (DIP) was recognized in the early 1950s as a
More informationUnmet Needs for Parkinson s Disease Therapeutics
Unmet Needs for Parkinson s Disease Therapeutics Coalition Against Major Diseases & FDA Workshop October 20, 2014 Caroline M Tanner MD, PhD Director, Parkinson's Disease Research Education and Clinical
More informationChapter 372. Parkinson's Disease and Other Movement Disorders
Harrison's Principles of Internal Medicine, 18e > Chapter 372. Parkinson's Disease and Other Movement Disorders C. Warren Olanow; Anthony H.V. Schapira Parkinson's Disease and Related Disorders Parkinson's
More informationABC s of Parkinson s Disease 4/29/15 Karen Parenti, MS, PsyD
ABC s of Parkinson s Disease 4/29/15 Karen Parenti, MS, PsyD What is Parkinson s Disease? Parkinson's disease is a progressive disorder of the nervous system that affects movement. It develops gradually,
More informationdrug treatments for parkinson s
drug treatments for parkinson s While there is no cure yet for Parkinson s, there are many different drugs that can help manage the symptoms. This booklet is for people with Parkinson s and their families.
More informationPart 1 of a 6-Part Series
Release Date: April 1, 2003. Termination Date: April 1, 2004. Estimated time to complete this 6-part newsletter series: 3.0 hours. For additional updates, go to www.projectsinknowledge.com Awake and Involved:
More informationManagement in the pre-hospital setting
Management in the pre-hospital setting Inflammation of the joints Two main types: Osteoarthritis - cartilage loss from wear and tear Rheumatoid arthritis - autoimmune disorder Affects all age groups,
More informationParkinson's Disease Glossary
Parkinson's Disease Glossary A guide to the scientific language of Parkinson s disease for the non-scientist Acetylcholine: One of the chemical neurotransmitters in the brain and other areas of the central
More informationCOMPASS Therapeutic Notes on Management of Parkinson s Disease
COMPASS Therapeutic Notes on Management of Parkinson s Disease In this issue Page Introduction 1 Drug Treatment in 3 early PD Motor 9 complications Depression in PD 11 Dementia in PD 13 Psychosis in PD
More informationUnderstanding Antipsychotic Medications
Understanding Antipsychotic Medications NARSAD RESEARCH National Alliance for Research on Schizophrenia and Depression 60 Cutter Mill Road, Suite 404 Great Neck, NY 11021 516-829-0091 1-800-829-8289 516-487-6930
More informationWhat s New in Multiple Sclerosis and Parkinson Disease?
What s New in Multiple Sclerosis and Parkinson Disease? Eric S. Farbman, MD University of Nevada School of Medicine Division of Neurology Director of Movement Disorders Center Disclosures Member of Parkinson
More informationParkinson Disease Levodopa-Induced Dyskinesia. Christopher Kenney, MD Novartis Pharmaceuticals
Parkinson Disease Levodopa-Induced Dyskinesia Christopher Kenney, MD Novartis Pharmaceuticals Disclosures Dr. Kenney is a full-time employee of Novartis Pharmaceuticals Corporation The opinions expressed
More informationEmergency management of patients with Parkinson s
Emergency management of patients with Parkinson s Missing doses of Parkinson s medication increases care needs and can cause serious complications, including rare but potentially fatal neuroleptic-like
More informationPublic Assessment Report. Dopamine agonists: pathological gambling and increased libido TABLE OF CONTENTS
Public Assessment Report Dopamine agonists: pathological gambling and increased libido TABLE OF CONTENTS Summary 2 Introduction 4 Data considered 5 Published literature 9 Discussion 14 Conclusions and
More informationChad Christine, MD UCSF
Parkinsonism: Clinical Features and Treatments Parkinson's disease is a condition whose main features are slowed movement, tremor, and gait or balance problems. More than1 million people in the United
More informationdrug treatments for parkinson s
drug treatments for parkinson s 1 While there is no cure yet for Parkinson s, there are many different drugs that can help manage the symptoms. This booklet is for people with Parkinson s and their families.
More informationEBM Parkinson s Diseases
Parkinson s Diseases Version 1 Final Page 1 Document control Version history Version Date Comments 1e (draft) 30 March 2007 Comments from customer incorporated 1d (draft) 22 January 2007 Formatting 1c
More informationNEUROIMAGING in Parkinsonian Syndromes
NEUROIMAGING in Parkinsonian Syndromes (Focus on Structural Techniques: CT and MRI) Dr. Roberto Cilia Parkinson Institute, ICP, Milan, Italy OUTLINE Primary Parkinsonism Idiopathic Parkinson s Disease
More informationPARKINSONISM. akinetic-rigid syndrome
PARKINSONISM PARKINSONISM akinetic-rigid syndrome PARKINSONISM Symptoms of Parkinson s disease: akinesia, bradykinesia, rigidity, postural instability, gait impairment, tremor A common, age-related syndrome
More informationWhat You Need to Know About Xenazine
Note to Healthcare Professionals: Please provide this guide to your patient or your patient s caregiver. What You Need to Know About Xenazine (tetrabenazine) Patient/Caregiver Counseling Guide This guide
More informationMEDICATIONS AND PARKINSON'S DISEASE Cathi A.Thomas R.N., M.S.
MEDICATIONS AND PARKINSON'S DISEASE Cathi A.Thomas R.N., M.S. Medications to relieve or decrease symptoms of Parkinson s disease are an important and necessary part of care. For some people this may be
More informationDiagnosing Parkinson s disease (PD) in
MedicineToday 2015; 16(1): 12-18 PEER REVIEWED FEATURE 2 CPD POINTS The clinical challenge of early Parkinson s disease SIMON J.G. LEWIS MB BCh, BSc, MRCP, FRACP, MD Early Parkinson s disease may be challenging
More informationDiagnosis and Treatment of Parkinson s Disease: A Systematic Review of the Literature
Evidence Report/Technology Assessment Number 57 Diagnosis and Treatment of Parkinson s Disease: A Systematic Review of the Literature Prepared for: Agency for Healthcare Research and Quality U.S. Department
More information1/25/2015. Idiopathic restless legs syndrome: clinical definition, pathophysiology and treatment. Five essential criteria (all must be met)
Idiopathic restless legs syndrome: clinical definition, pathophysiology and treatment Joan Santamaria, MD Neurology service, Multidisciplinary Sleep Disorders Unit Hospital Clínic de Barcelona University
More informationSUMMARY OF RECOMMENDATIONS
SUMMARY OF RECOMMENDATIONS FOR THE LONG- TERM TREATMENT OF RLS/WED from AN IRLSSG TASK FORCE Members of the Task Force Diego Garcia- Borreguero, MD, Madrid, Spain* Richard Allen, PhD, Baltimore, MD, USA*
More informationCircuit Disorders of the Basal Ganglia: Parkinson s Disease Pathophysiology and Surgical Treatments
Circuit Disorders of the Basal Ganglia: Parkinson s Disease Pathophysiology and Surgical Treatments Mahlon R. DeLong M.D. W. P. Timmie Professor of Neurology Emory University School of Medicine The Basal
More informationIntroduction to Psychology, 7th Edition, Rod Plotnik Module 3: Brain s Building Blocks. Module 3. Brain s Building Blocks
Module 3 Brain s Building Blocks Structure of the Brain Genes chains of chemicals that are arranged like rungs on a twisting ladder there are about 100,000 genes that contain chemical instructions that
More informationcme: The Current Treatment of Parkinson's Disease
cme: The Current Treatment of Parkinson's Disease Lars Wojtecki, Martin Südmeyer, Alfons Schnitzler SUMMARY Introduction: Parkinson s disease is a neurodegenerative disease characterized by akinesia, rigidity,
More informationIllinois Department of Revenue Regulations TITLE 86: REVENUE CHAPTER I: DEPARTMENT OF REVENUE
Illinois Department of Revenue Regulations Title 86 Part 530 Section 530.110 Covered Prescription Drugs TITLE 86: REVENUE CHAPTER I: DEPARTMENT OF REVENUE PART 530 SENIOR CITIZENS AND DISABLED PERSONS
More informationThe Neuron and the Synapse. The Neuron. Parts of the Neuron. Functions of the neuron:
The Neuron and the Synapse The Neuron Functions of the neuron: Transmit information from one point in the body to another. Process the information in various ways (that is, compute). The neuron has a specialized
More informationPARKINSON'S DISEASE The Disorder and Current Therapy Copyright 2008, Daniel Kassicieh, D.O.
PARKINSON'S DISEASE The Disorder and Current Therapy Copyright 2008, Daniel Kassicieh, D.O. Parkinson's disease is a common neurologic disorder. It affects people of all ages and ethnic backgrounds and
More informationLevels of evidence and grades of recommendation
MOH Clinical Practice Guidelines 6/2007 Levels of evidence and grades of recommendation Levels of Evidence Level Type of Evidence 1 ++ High quality meta analyses, systematic reviews of RCTs, or RCTs with
More informationParkinsonism What makes it different?
What is Parkinsonism? Parkinsonism What makes it different? Praween Lolekha, MD. MSc. Neurology division, Department of Internal Medicine Thammasat University A motor syndrome with the following cardinal
More informationNursing Care of Patients with Movement Disorders. Catholic Health 2 nd Annual Neurorehab Symposium November 1, 2014
Nursing Care of Patients with Movement Disorders Catholic Health 2 nd Annual Neurorehab Symposium November 1, 2014 Types of Movement Disorders Parkinson s disease Huntington s disease Dystonia Tremors
More informationRörelserubbningar och Parkinson, hur svårt kan det vara. En översikt och problematisering av en folksjukdom Örjan Skogar, MD,PhD
Rörelserubbningar och Parkinson, hur svårt kan det vara En översikt och problematisering av en folksjukdom Örjan Skogar, MD,PhD Man räknar med att 11-19 personer /100 000 invånare insjuknar i Parkinson
More informationSLEEP DIFFICULTIES AND PARKINSON S DISEASE Julie H. Carter, R.N., M.S., A.N.P.
SLEEP DIFFICULTIES AND PARKINSON S DISEASE Julie H. Carter, R.N., M.S., A.N.P. Problems with sleep are common in Parkinson s disease. They can sometimes interfere with quality of life. It is helpful to
More informationDisordered sleep at night has long been
Neurology 59 Excessive daytime sleepiness in PD Excessive Daytime Sleepiness (EDS) in Parkinson s disease (PD) is an important issue that warrants serious attention because it can have adverse effects
More informationPARKINSON S DISEASE INTRODUCTION. Parkinson s disease is defined as a disease of the nervous system that affects voluntary movement.
PARKINSON S DISEASE INTRODUCTION Parkinson s disease is a disorder of the brain and the nervous system. It is one of the more common neurological diseases in people over the age of 60, and it is more common
More informationParkinson s Disease Medications
Parkinson s Disease Medications By David Houghton, MD, MPH, Howard Hurtig, MD, and Sharon Metz, RN, MPH, with guest author Melanie Brandabur, MD Table of Contents Chapter 1 Introduction to Parkinson s
More informationParkinson s Disease. Challenges, Progress and Hope
Parkinson s Disease Challenges, Progress and Hope Parkinson s Disease: Challenges, Progress and Hope Course #226 5 Contact Hours Author: Ellen Steinbart, RN, MA Course Material valid through 09/2016 Copyright
More informationManagement of Parkinson s disease and co-existent health problems is a long journey, requiring a multidisciplinary team approach.
Diagnosis and management of Parkinson s Disease Key points 1. 2. 3. 4. 5. 6. The diagnosis of Parkinson s disease is still based on careful history taking and clinical examination, despite ongoing advances
More informationNEURON AND NEURAL TRAMSMISSION: ANATOMY OF A NEURON. created by Dr. Joanne Hsu
NEURON AND NEURAL TRAMSMISSION: ANATOMY OF A NEURON NEURON AND NEURAL TRAMSMISSION: MICROSCOPIC VIEW OF NEURONS A photograph taken through a light microscope (500x) of neurons in the spinal cord. NEURON
More informationParkinson s Disease: General Information
Parkinson s Disease: General Information Does PD come in stages? If so, how many stages? Hubert Fernandez, MD: Staging provides an artificial classification of a patient's illness severity but, in reality,
More informationUnderstanding tardive dyskinesia
Understanding tardive dyskinesia 1 Contents What is tardive dyskinesia? 3 What does TD look like? 3 What might affect the risk of me getting TD? 4 Will TD disappear if I stop my medication? 5 What else
More informationContemporary Psychiatric-Mental Health Nursing. Assessing the Effectiveness of Medications. Administering Medications
Contemporary Psychiatric-Mental Health Nursing Chapter 32 Psychopharmacologic Nursing Interventions Assessing the Effectiveness of Medications Include how well the medications are helping the client to
More informationA GUIDE FOR THE NEW PATIENT. supported by the Neurological Foundation
PARKINSON S A GUIDE FOR THE NEW PATIENT supported by the Neurological Foundation INTRODUCTION 1 Contents 1. Introduction 2. Parkinson s 3. The main symptoms of Parkinson s 6. What causes Parkinson s? 7.
More informationPARKINSON S DISEASE IN LONG-TERM-CARE SETTINGS
PARKINSON S DISEASE IN LONG-TERM-CARE SETTINGS De Anna Looper, RN CHPN Corporate Clinical Consultant / Legal Nurse Consultant Carrefour Associates L.L.C. PARKINSON S DISEASE IN LONG-TERM-CARE SETTINGS
More informationPRODUCT MONOGRAPH. Pr PROLOPA. levodopa and benserazide combination. Capsules 50-12.5, 100-25, 200-50. Pharmaceutical standard: professed
PRODUCT MONOGRAPH Pr PROLOPA levodopa and benserazide combination Capsules 50-12.5, 100-25, 200-50 Pharmaceutical standard: professed Antiparkinson Agent Hoffmann-La Roche Limited Date of Preparation:
More informationManagement of hand tremor in Primary care setting. Specialist in Family Medicine
Management of hand tremor in Primary care setting Dr. Ko Wai Kit, Welchie Specialist in Family Medicine Types of hand tremor Causes of hand tremor How to approach a hand tremor patient Management of
More information2015 RN.ORG, S.A., RN.ORG, LLC
Parkinson s Disease WWW.RN.ORG Reviewed September, 2015, Expires September, 2017 Provider Information and Specifics available on our Website Unauthorized Distribution Prohibited 2015 RN.ORG, S.A., RN.ORG,
More informationBenzodiazepines: A Model for Central Nervous System (CNS) Depressants
Benzodiazepines: A Model for Central Nervous System (CNS) Depressants Objectives Summarize the basic mechanism by which benzodiazepines work in the brain. Describe two strategies for reducing and/or eliminating
More informationEmergency Room Treatment of Psychosis
OVERVIEW The term Lewy body dementias (LBD) represents two clinical entities dementia with Lewy bodies (DLB) and Parkinson s disease dementia (PDD). While the temporal sequence of symptoms is different
More informationMovement disorders and gait disturbances. Kovács Norbert PTE ÁOK Neurológiai Klinika Pécs
Movement disorders and gait disturbances Kovács Norbert PTE ÁOK Neurológiai Klinika Pécs 1 MD pathophysiology Genetic mutation or environmental injury of basal ganglia functioning Pallidum, thalamus, subthalamic
More informationTreatments for Major Depression. Drug Treatments The two (2) classes of drugs that are typical antidepressants are:
Treatments for Major Depression Drug Treatments The two (2) classes of drugs that are typical antidepressants are: 1. 2. These 2 classes of drugs increase the amount of monoamine neurotransmitters through
More informationParkinson s disease is a progressive. Parkinson s Disease: Diagnosis and Treatment
: Diagnosis and Treatment SHOBHA S. RAO, M.D., LAURA A. HOFMANN, M.D., and AMER SHAKIL, M.D., University of Texas Southwestern Medical School at Dallas Family Medicine Residency Program, Dallas, Texas
More informationCAMBRIDGE UNIVERSITY CENTRE FOR BRAIN REPAIR A layman's account of our scientific objectives What is Brain Damage? Many forms of trauma and disease affect the nervous system to produce permanent neurological
More informationObsessive Compulsive Disorder: a pharmacological treatment approach
Obsessive Compulsive Disorder: a pharmacological treatment approach Professor Alasdair Vance Head, Academic Child Psychiatry Department of Paediatrics University of Melbourne Royal Children s Hospital
More informationIf you have been taking a Parkinson s drug that contains levodopa,
Symptoms and lifestyle Wearing off and involuntary movements (dyskinesia) If you have been taking a Parkinson s drug that contains levodopa, for example co-beneldopa or co-careldopa, for some time, you
More informationSymptomatic treatment of Parkinson s disease: The role of transdermal iontophoretic delivery of dopamine agonists
Symptomatic treatment of Parkinson s disease: The role of transdermal iontophoretic delivery of dopamine agonists CHAPTER 1 1 Introduction Parkinson s disease (Pd) is an age-related neurodegenerative disorder.
More informationPARKINSON S DISEASE MULTIPLE DOMAINS
PhD PROGRAM IN NEUROPHARMACOLOGY UNIVERSITY OF CATANIA SUMMER SCHOOL OF NEUROSCIENCE (5) Quinta scuola estiva di Neuroscienze (5) July 7-13, 2007 PARKINSON S DISEASE MULTIPLE DOMAINS Catania Parco degli
More informationParkinson s disease (PD) is a progressive neurodegenerative
n reports n Advanced Strategies for Treatment of Parkinson s Disease: The Role of Early Treatment Michael W. Jann, PharmD Parkinson s disease (PD) is a progressive neurodegenerative disease associated
More informationCommon causes of dementia
Common causes of dementia Alzheimer s disease vascular (multi-infarct etc.) dementia dementia of Parkinsonism Huntington s disease Pick s disease Creutzfeldt-Jacob disease etc. DEGENERATIVE DEMENTIA Pick
More information