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Doenca de parkinson
1.
DOENÇA DE PARKINSON
2.
Doença de
PPaarrkkiinnssoonn oouu MMaall ddee PPaarrkkiinnssoonn.. DDooeennççaa ddeeggeenneerraattiivvaa,, ccrrôônniiccaa ee pprrooggrreessssiivvaa qquuee ooccoorrrree pprriinncciippaallmmeennttee nnaa vveellhhiiccee.. OOccoorrrree ppeellaa ppeerrddaa ddee nneeuurrôônniiooss ddoo SSNNCC eemm uummaa rreeggiiããoo ccoonnhheecciiddaa ccoommoo ssuubbssttâânncciiaa nneeggrraa oouu ssuubbssttâânncciiaa nniiggrraa..
3.
Substância Negra: porção
heterogênea do mesencéfalo responsável pela produção de dopamina (DOPA) no cérebro.
4.
Dopamina: neurotransmissor atuante
no circuito da Recompensa.
5.
Neurônios ddeessttaa
áárreeaa ssiinntteettiizzaamm oo nneeuurroottrraannssmmiissssoorr DDooppaammiinnaa,, ccuujjaa ddiimmiinnuuiiççããoo pprroovvooccaa ssiinnttoommaass pprriinncciippaallmmeennttee mmoottoorreess.. PPooddee ooccoorrrreerr oouuttrrooss ssiinnttoommaass ccoommoo ddeepprreessssããoo,, aalltteerraaççõõeess ddoo ssoonnoo,, ddiimmiinnuuiiççããoo ddaa mmeemmóórriiaa ee ddiissttúúrrbbiiooss ddoo ssiisstteemmaa nneerrvvoossoo aauuttôônnoommoo..
6.
PRINCIPAIS SINTOMAS
Tremor em repouso, ggeerraallmmeennttee ccoommeeççaannddoo nnaass mmããooss.. RRiiggiiddeezz mmuussccuullaarr.. DDiimmiinnuuiiççããoo ddaa vveelloocciiddaaddee ddooss mmoovviimmeennttooss ((hhiippoocciinneessiiaa)).. DDiissttúúrrbbiiooss ddoo eeqquuiillííbbrriioo ee ddaa mmaarrcchhaa..
7.
TRATAMENTO FARMACOLÓGICO
8.
LEVODOPA Fármaco
qquuee ssuubbssttiittuuii aa ddooppaammiinnaa.. ÉÉ qquuaassee sseemmpprree ccoommbbiinnaaddoo ccoomm ccaarrbbiiddooppaa oouu bbeennsseerraazziiddaa ((rreedduuzz aa ddoossee nneecceessssáárriiaa ee ddiimmiinnuuii ooss eeffeeiittooss ccoollaatteerraaiiss ppeerriifféérriiccooss)).. BBeemm aabbssoorrvviiddoo ppeelloo iinntteessttiinnoo ddeellggaaddoo.. QQuuaannddoo aa ddooeennççaa aavvaannççaa aa eeffiiccáácciiaa tteerraappêêuuttiiccaa ddiimmiinnuuii..
9.
LEVODOPA Efeitos indesejáveis
DISCINESIA: eeffeeiittooss iinnvvoolluunnttáárriiooss ddee ssee ccoonnttoorrcceerr ((22 aannooss aappóóss oo iinníícciioo ddoo ttrraattaammeennttoo)).. AAffeettaamm aa ffaaccee ee ooss mmeemmbbrrooss ee ppooddeemm ttoorrnnaarr –– ssee mmuuiittoo sseevveerrooss.. DDeessaappaarreecceemm ssee aa ddoossee ffoorr rreedduuzziiddaa,, mmaass iissssoo ccaauussaa rreettoorrnnoo ddaa rriiggiiddeezz..
10.
LEVODOPA Efeitos indesejáveis
EFEITO ON – OFF: fflluuttuuaaççõõeess nnoo eessttaaddoo ccllíínniiccoo.. HHiippoocciinneessiiaa ee rriiggiiddeezz ppooddeemm ppiioorraarr rreeppeennttiinnaammeennttee ddee ppoouuccooss mmiinnuuttooss aa ppoouuccaass hhoorraass ee nnoovvaammeennttee mmeellhhoorraarr.. RReefflleetteemm aa vvaarriiaaççããoo ddaa ccoonncceennttrraaççããoo ppllaassmmááttiiccaa ddaa lleevvooddooppaa:: ddeeppeennddee ddee uumm ssuupprriimmeennttoo ccoonnttíínnuuoo ddee lleevvooddooppaa..
11.
LEVODOPA Efeitos indesejáveis:
efeitos agudos Ocorrem no início ee tteennddeemm aa ddeessaappaarreecceerr eemm aallgguummaass sseemmaannaass.. NNááuusseeaa ee aannoorreexxiiaa.. HHiippoonntteennssããoo.. EEffeeiittooss ppssiiccoollóóggiiccooss:: ssíínnddrroommee sseemmeellhhaannttee aa eessqquuiizzooffrreenniiaa ccoomm aalluucciinnaaççõõeess,, ccoonnffuussããoo,, ddeessoorriieennttaaççããoo,, iinnssôônniiaa oouu ppeessaaddeellooss..
12.
POSOLOGIA Carbidopa
+ Levodopa 2255mmgg//225500mmgg oouu 5500mmgg//220000mmgg AAdduullttoo:: vviiaa oorraall –– 22 aa 44 vveezzeess aaoo ddiiaa llooggoo aappóóss ààss rreeffeeiiççõõeess.. NNoommeess ccoommeerrcciiaaiiss:: PPaarrkkiiddooppaa,, CCrroonnoommeett,, LLeevvooccaarrbb,, SSiinneemmeett..
13.
SELEGINA Inibe
a enzima mmoonnooaammiinnaa –– ooxxiiddaassee bbllooqquueeaannddoo oo ccaattaabboolliissmmoo ddaa ddooppaammiinnaa.. SSoobbrraa mmaaiiss ddooppaammiinnaa ddiissppoonníívveell.. AAssssoocciiaaddaa àà LLeevvooddooppaa:: pprrootteeggee aa ddooppaammiinnaa ddaa ddeeggrraaddaaççããoo iinnttrraanneeuurraall..
14.
SELEGINA Efeitos indesejáveis
Agitação psicomotora, aalltteerraaççããoo ddoo ppaallaaddaarr,, aalluucciinnaaççããoo,, aauummeennttoo ddooss bbaattiimmeennttooss ccaarrddííaaccooss,, ccoonnffuussããoo mmeennttaall,, bbooccaa sseeccaa,, ccóólliiccaa ggaassttrriinntteessttiinnaall,, eettcc........
15.
POSOLOGIA Iniciar
com 2, 5 mmgg nnoo ccaafféé ddaa mmaannhhãã,, dduurraannttee 22 ddiiaass.. DDeeppooiiss aauummeennttaarr aa ddoossee,, iinnggeerriinnddoo mmaaiiss 22,, 55 mmgg nnoo jjaannttaarr ppoorr mmaaiiss 22 ddiiaass.. AA mmaannuutteennççããoo ddeevvee lleevvaarr eemm ccoonnttaarr aallgguunnss ffaattoorreess.. DDoossee mmááxxiimmaa:: 1100 mmgg ppoorr ddiiaa..
16.
OUTROS FÁRMACOS UTILIZADOS
Agonistas ddoo rreecceeppttoorr ddee ddooppaammiinnaa:: BBrroommooccrreeppttiinnaa,, aappoommoorrffiinnaa,, lliissuurriiddaa,, ppeerrggoolliiddaa,, pprraammiippeexxooll.. AAmmaannttaaddiinnaa:: aauummeennttaa aa lliibbeerraaççããoo ddee ddooppaammiinnaa.. AAnnttaaggoonniissttaass ddaa aacceettiillccoolliinnaa..
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