Anti-Parkinsonian drugs are drugs which slow the progression or otherwise reduce the effects of Parkinson's disease.

1. Definition
Anti-Parkinsonian drugs aredrugs which slowthe progression or otherwise reduce the effects of Parkinson's
disease.
Overview
Parkinson's diseaseis a progressivenervous system disorder thataffects movement. Symptoms startgradually,
sometimes startingwith a barely noticeabletremor in justone hand. Tremors are common, but the disorder also
commonly causes stiffness or slowingof movement.
In the early stages of Parkinson'sdisease,your facemay show littleor no expression.Your arms may not swing
when you walk. Your speech may become soft or slurred.Parkinson'sdiseasesymptoms worsen as your condition
progresses over time.
Although Parkinson'sdiseasecan'tbecured, medications mightsignificantly improveyour symptoms. Occasionally,
your doctor may suggest surgery to regulate certain regions of your brain and improveyour symptoms.
What are anti-Parkinson's drugs?
Anti-Parkinsons drugs areintended primarily for treatingParkinson'sdisease.They are not psychiatric drugs,which
means they are not licenced to treat any mental health problems. However they may be prescribed alongsidean
antipsychotic to reduce neuromuscular sideeffects which resemble symptoms of Parkinson’s disease.
The three anti-Parkinson'sdrugs which may be prescribed with antipsychoticsare:
 orphenadine(Biorphen, Disipal)
 procyclidine(Arpicolin,Kemadrin)
 trihexyphenidyl (formerly called benzhexol)
Anti-Parkinson's drugs aresometimes referred to as 'antimuscarinics' becausetheir main sideeffects are
antimuscarinic.There are no significantdifferences between these drugs,but you may find that you tolerate one
better than another.
Symptoms
Parkinson's diseasesignsand symptoms can be different for everyone. Early signs may be mild and go unnoticed.
Symptoms often begin on one sideof your body and usually remain worseon that side, even after symptoms begin
to affect both sides.
Parkinson's signsand symptoms may include:
 Tremor. A tremor, or shaking,usually begins in a limb,often your hand or fingers. You may a rub your
thumb and forefinger back-and-forth,known as a pill-rollingtremor. Your hand may tremor when it's at
rest.
 Slowed movement (bradykinesia). Over time, Parkinson'sdiseasemay slowyour movement, making
simpletasks difficultand time-consuming.Your steps may become shorter when you walk.It may be
difficultto get out of a chair.You may drag your feet as you try to walk.

2.  Rigid muscles. Musclestiffness may occur in any partof your body. The stiff muscles can be painful and
limityour range of motion.
 Impaired posture and balance. Your posture may become stooped, or you may have balanceproblems as
a resultof Parkinson'sdisease.
 Loss of automatic movements. You may have a decreased ability to perform unconscious movements,
includingblinking,smilingor swingingyour arms when you walk.
 Speech changes. You may speak softly,quickly,slur or hesitatebefore talking.Your speech may be more
of a monotone rather than with the usual inflections.
 Writing changes. It may become hard to write, and your writingmay appear small.
Parkinson’s disease
Parkinson's diseaseis a progressivedisorder of the nervous system that affects your movement. Young adults
rarely experience Parkinson's disease.Itordinarily begins in middleor latelife,and the risk increases with age.
People usually develop the diseasearound their sixties or older.Men areone-and-a-half times more likely to get
Parkinson’s diseasethan women.
The symptoms of Parkinson’sdiseasemay vary from person to person. However, symptoms often begin on one
sideof your body and are usually related to movement. Well known symptoms of Parkinson’s diseaserelated to
movement includetremor (involuntary shakingof particular parts of the body, usually begins in a limb) which is
worse at rest, rigidity (musclestiffness of limbs and joints which limittherange of motion) and bradykinesia
(physical movements become very slow).Other symptoms unrelated to movement includedepression,daytime
sleepiness,difficultiesin swallowingand speech problems.
Parkinson’s diseaseis caused by the gradual break down or death of certain nerve cells in the brain.This leads to a
reduction in the amount of a chemical called dopaminein the brain.When dopamine levels decrease, itcauses
abnormal brain activity,leadingto various symptoms of Parkinson'sdisease.
Treatment used
Although Parkinson'sdiseasecan'tbecured, treatments are availableto help reduce symptoms and maintain
quality of life.These includesupportivetherapies such as physiotherapy,occupational therapy and psychological
counsellingthathelp you cope with everyday life,or medication to control your symptoms. Surgical procedures
such as deep brain stimulation may be used under the direction of doctors.
Antiparkinsonian drugs aremedicines used to treat the symptoms of Parkinson'sdisease.The majority of the
registered antiparkinsonian drugs in HongKong are availablein oral dosageforms e.g. tablets, capsules;whilea
few of them are presented in injectableforms and transdermal patches.
Oral antiparkinsonian drugs
Antiparkinsonian drugs consistlargely of the use of dopaminergics or antimuscarinicsin an attempt to restore the
normal balancebetween dopaminergic and cholinergic activity.Drugs with different actions may be necess ary to
achieveoptimum control of symptoms. The medications may include:
 Levodopa: this drugis the most effective medication to control the symptoms of Parkinson's disease.Itis
absorbed by the nerve cells in your brain and is converted to dopamine. Levodopa is usually combined
with a peripheral dopa-decarboxylaseinhibitor such as benserazideor carbidopa.Dopa-decarboxylase

3. inhibitors preventthe breakdown of levodopa in the gut, which allows effective concentrations of
dopamine to be achieved in the brain with lower doses of levodopa, and also reduces sideeffects such as
nausea and vomiting.
 Dopamine agonists: they actas a substitute for dopamine in the brain and havea directaction on
dopamine receptors. They are not as effective as levodopa in improvingthe symptoms of Parkinson's
disease.However, they are less likely to causemuscleproblems than levodopa and are used to treat early
Parkinson’s disease.Examples includepramipexole,ropinirole,bromocriptineand cabergoline.
 Monoamine oxidase-B (MAO-B) inhibitors: they block the effects of an enzyme called monoamine
oxidase-Bin the brain thatmetabolizes or breakdown brain dopamine.They are used as an alternativeto
levodopa for treating early Parkinson’s disease.Examples includeselegilineand rasagiline.
 Catechol O-methyltransferase (COMT) inhibitors: they prevent the peripheral breakdown of levodopa,by
inhibitingan enzyme called catechol-O-methyltransferase(COMT). Adding a peripheral COMT inhibitor
can therefore extend the duration and effect of levodopa in the brain,and allowlower and less frequent
doses of levodopa. They are usually prescribed for people in later stages of Parkinson’s disease.Examples
includeentacapone.
 Antimuscarinics: they have a weak antiparkinsonian effectcompared with levodopa.They reduce tremor
and rigidity but have littleeffect on bradykinesia.Antimuscarinic sideeffects, particularly cognitive
impairment, occur frequently and can limittheir use. Examples includeorphenadrineand benztropine.
 Amantadine: itis a weak dopamine agonistwith some antimuscarinic activity.Ithas mild antiparkinsonian
effects compared with levodopa.It may be used aloneto provideshort-term relief of symptoms of mild,
early-stageParkinson'sdisease,and may also be given with levodopa therapy duringthe later stages of
the diseaseto control involuntary movements induced by levodopa.
Side effects
These drugs have many sideeffects and drugspecific references should be consulted.The most significantadverse
effect of levodopa is involuntary movement or dyskinesia,and this can occur atlower doses when levodopa is
administered with carbidopa.Onestudy indicates thatthis effect might be related to the doselevel, and careful
dosingshould reduce the risk.An Italian reportindicates thatpost-menopausal women might benefit from
hormone replacement therapy in reducingdyskinesia.
for more information visitus our website : https://www.mymedistore.com/