ROLE OF THE PATIENT

1. INTEGRAL UNIVERSITY, LUCKNOW
M.Pharm Ist Year
2016
PRESENTED BY:-
MOHD.FAHAD
GUIDED BY:-
Dr. Mohd. Mujahid

2.  Parkinson disease is a brain disorder. It occurs
when certain nerve cells (neurons) in a part of the
brain called the substantia nigra die or become
impaired. Normally, these cells produce a vital
chemical known as dopamine. Dopamine allows
smooth, coordinated function of the body's
muscles and movement. When approximately
80% of the dopamine-producing cells are
damaged, the symptoms of Parkinson disease
appear.

3. The key signs of Parkinson disease are:
 Tremor (shaking)
 Slowness of movement
 Rigidity (stiffness)
 Difficulty with balance
Other signs of Parkinson disease may include:
 Small, cramped handwriting
 Stiff facial expression
 Shuffling walk
 Muffled speech
 Depression

4.  Early symptoms of PD are subtle and occur
gradually. In some people the disease progresses
more quickly than in others. Slow progressively
moving disease.

5.  Parkinson disease affects both men and women in
almost equal numbers. It shows no social, ethnic,
economic or geographic boundaries. In the United
States, it is estimated that 60,000 new cases are
diagnosed each year, joining the 1.5 million Americans
who currently have Parkinson disease. While the
condition usually develops after the age of 65, 15% of
those diagnosed are under 50.

6.  Genetics – 15 – 25% of people with Parkinson's report
having a relative with the disease . The vast majority of
Parkinson's cases are not directly inherited, but
researchers have discovered several genes that can
cause the disease in a small number of families.
 Environmental Factors - Epidemiological research has
identified several factors that may be linked to PD,
including rural living, well water, herbicide use and
exposure to pesticides.
 There is though no evidence to prove there is
environmental factors that cause Parkinsons.

7.  Carbidopa/Levodopa-may cause- low blood pressure,
nausea, confusion, dry mouth, dizziness.
 Carbidopa/Levodopa-(controlled release) may cause-low
blood pressure, nausea, confusion, dry mouth,
dizziness.
 Carbidopa/Levodopa- Entacapone-may cause- nausea,
diarrhea, abdominal pain, dizziness, harmless
discoloration of urine, saliva and/or sweat.
 Along with these medications you can take Dopamine-
which is a drug that stimulates the parts of the human
brain that receive dopamine.

8.  Vitamin E- has been suggested to lower the risk of
PD risk.
 Health Food- papaya and blueberries have been
suggested to slow nerve cell death.
Neither one of these medications have provided any
real evidence that they slow down the progression
of Parkinson’s or manages symptoms.

9.  Newest Version of surgery- DBS, (deep brain stimulation)
this was developed in 1990 and is the standard treatment.
-How this surgery is done –
Electrodes are inserted into the targeted brain region using MRI
and neurophysiological mapping to ensure that they are in
the right place. Next an impulse generator or IPG (similar to
a pacemaker) is implanted under the collarbone to provide
an electrical impulse to a part of the brain involved in motor
function. Patients have a controller, which allows them to
check the battery and to turn the device on or off. An IPG
battery lasts for three to five years and is easy to replace
under local anesthesia.

10. Has No Known Cure

12.  Patient and Doctor relationship
 Exercise
 Support Groups
 Diet
 Physical, Speech and Occupational Therapy
 Clinical Trials
The Role of the Patients are-

13.  Choosing a doctor is very important for a person
with parkinson’s since they may work with a
doctor for many years.
 A person should feel comfortable communicating
with their neurologist.
 A person should have an open line of
communication with their neurologist.

14.  Support groups can provide a caring
environment for asking questions about
parkinson’s.
 People who attend support groups can share
stories, form friendships and trade advice with
people who have experienced similar problems.
 Many people find online support groups
beneficial.
 To find a support group a person can call or
email the Parkinsons Disease Foundation.

15.  A poor appetite and inadequate food intake affect
many people who have parkinsons.
 A person who has parkinsons should maintain a
full diet that contains all the daily nutritional
requirements.
 Extra fresh fruits and vegetables can help prevent
constipation’
 Drinking plenty of fluids can help prevent
dehydration.

16.  These types of therapies can help parkinsons
patients control their symptons and make their
daily life easier.
 Physical therapy may increase muscle strength.
 Speech therapy can help increase voice volume
and assist with word pronunciations.
 Occupational therapy give people alternative
methods of doing tasks that they can no longer
perform with ease.

17.  Clinical trials help researchers answer specific
questions about the safety and efficacy of new
treatments by studying its effects on people.
 Clinical trials are essential and necessary
components of the scientific research process.
 Without clinical trials and research there would not
be a possibility of finding a cure in the future.

18.  Israeli researchers at the Fourth International Scientific Symposium
on Tea and Human Health in Washington D.C. experimented with
animal neurons that had been chemically poisoned to model the
death of dopamine producing cells in Parkinson’s Disease.
 In this test tube study, low doses of epigallocatechin gallate (EGCG)
revived sick and dying neurons. The withered cells became fatter
and more robust.
 Second study mice got oral doses of EGCG (comparable to what
me might receive from 3 – 4 cups of green tea)for 2 weeks after the
animals already lost about half their dopamine making cells.
Dopamine production rebounded for these animals. Not sure yet if it
permenently rescued the cells or just bought the animals extra time.

19.  Parkinson’s Disease has been connected to exposure to
pesticides. People exposed to low levels of pesticides
had a 9 percent higher risk of developing Parkinson's,
say the researchers, who work at Aberdeen University.
People exposed to high levels had a 39 percent greater
risk. Several North American studies have also
connected Parkinson's and pesticides.
 The study also found that being knocked unconscious
ups the risk of Parkinson's. One knockout increased the
odds of getting the disease by 28 percent More than one
knockout increased the odds by 156 percent.

20. • People who exercise regularly and vigorously more than just
an occasional stroll around the block may see their efforts
rewarded with a lowered risk of Parkinson's disease. That's
the promising news from researchers at the Harvard School
of Public Health who found that subjects who were the most
active, performing 30 minutes of moderate to intense
physical exercise a day, had a 40% lower chance of
developing the disease.
• Gene therapy may be living up to its promise. Dramatic and
sustained improvements have been reported in the first
people to get gene therapy for Parkinson's disease. In all 12
patients, symptoms improved by at least 25 percent for up to
a year after the treatment, as measured by standard tests of
Parkinson's severity.

21. THANK YOU