Pharmacologic management of parkinsonism
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Pharmacologic management of parkinsonism Presentation Transcript

  • 1. Pharmacologic Management of Parkinsonism & Other Movement Disorders By M.H.Farjoo M.D. , Ph.D. Shahid Beheshti University of Medical Science
  • 2. Parkinson Disease  Parkinson Disease  Incidence & prevalence  Introduction  Treatment  Drug PicturesM.H.Farjoo
  • 3. Introduction of Parkinson  After james parkinson (1755–1824), British physician  Characterized by:  Rigidity  Bradykinesia  Tremor at rest  Postural instability  Is usually idiopathic  Reduction of dopamine in the basal ganglia of the brain  Normal balance of cholinergic and dopaminergic neurons is lostM.H.Farjoo
  • 4. Treatment of Parkinson  Dopamine?  Does not cross the blood-brain barrier  Levodopa?  Most of levodopa is metabolized extracerebrally to dopamine  Only 1–3% of levodopa enters the brain  Combination with a Dopa decarboxylase inhibitor (Carbidopa) is necessary  Best results are obtained in the first few years of treatmentM.H.Farjoo
  • 5. Treatment of Parkinson (Cont’d)  Adverse Effects of Levodopa:  Gastrointestinal Effects  Cardiovascular Effects  Dyskinesias  Behavioral Effects  Fluctuations in Response (on-off phenomenon)  brownish discoloration of saliva, urine, or vaginal secretionsM.H.Farjoo
  • 6. Treatment of Parkinson (Cont’d)  Dopamine Agonists  Monoamine Oxidase Inhibitors  Catechol-O-Methyltransferase Inhibitors  Acetylcholine-Blocking Drugs  Surgical ProceduresM.H.Farjoo
  • 7. Summary In English
  • 8. Thank you Any question?