Parkinson's disease is a progressive neurological disorder caused by the loss of dopamine-producing neurons in the brain. It is characterized by tremors, rigidity, slowness of movement, and impaired balance and coordination. There is no cure for Parkinson's, but treatment aims to manage symptoms through medications like levodopa and deep brain stimulation surgery. Nurses play an important role in assessing patients, educating on medication management, and supporting overall care and quality of life.
This document provides an overview of Parkinson's disease. It begins with an introduction describing Parkinson's as a progressive neurological disease caused by the death of dopamine-producing neurons in the substantia nigra. It then covers the history, epidemiology, signs and symptoms, management including medications and surgery, and nursing considerations for patients with Parkinson's disease. The document aims to give a comprehensive yet concise description of Parkinson's for healthcare professionals.
PARKINSON'S DISEASE And pathophysiology .pdf by SMH.pdfwajidullah9551
Parkinson's disease is a progressive neurological disorder caused by the loss of dopamine-producing neurons in the brain. It is characterized by tremors, rigidity, slow movement, and impaired balance. While there is no cure, treatment aims to manage symptoms through medications like levodopa and deep brain stimulation. Nurses focus on assessing symptoms, educating patients and families, and ensuring optimal management of this chronic condition.
This document provides an overview of Parkinson's disease, including its symptoms, stages of progression, causes, risk factors, diagnosis, and treatment options. Parkinson's is a progressive neurological disorder that results from the loss of dopamine-producing cells in the brain. Its primary symptoms are tremors, rigidity, bradykinesia, and postural instability. While there is no cure, treatments can help manage symptoms and maintain quality of life, such as medication to increase dopamine levels, surgery, physiotherapy, and deep brain stimulation.
parkinson's disease by me ..........prakash mahala p.g. medical surgical nursing at himalayan college of nursing dehradun.......prakashjpmmahala@gmail.com
This document discusses Parkinson's disease, including its definition, signs and symptoms, causes, pathophysiology, diagnosis, treatment, and nursing management. Parkinson's is a progressive nervous system disorder that causes movement issues like tremors and rigidity. It results from the loss of dopamine-producing neurons in the brain. While the exact cause is unknown, risk factors include age, genetics, and environmental toxins. Treatment focuses on increasing dopamine levels through medications or surgery. Nurses help manage symptoms, monitor for complications, and promote independence and safety.
TY BSc PAPER -5 Drugs & Dyes , Unit-2 Chapter : Anti-Parkinsonism drugs pravin bendle
1) Parkinson's disease is caused by depletion of dopamine in the brain and results in symptoms like tremors, rigidity, slow movement, and issues with posture, speech, and swallowing.
2) Anti-Parkinsonism drugs work by antagonizing neurotransmitters to block the origin of tremors and other symptoms. The main classes are anticholinergic agents and dopaminergic agents.
3) Levodopa is the most commonly used drug, as it can cross the blood brain barrier and be converted to dopamine to replace the depleted levels in Parkinson's patients. It is synthesized from vanillin and glycine in several steps.
Parkinson's disease is a degenerative disorder of the central nervous system that affects movement. It occurs when nerve cells in the brain do not produce enough dopamine. The document outlines the symptoms, stages, causes, treatment, and animal models of Parkinson's disease. The main symptoms are motor symptoms like tremors and rigidity as well as non-motor symptoms like mood changes. Treatment focuses on replacing dopamine and managing symptoms, primarily using levodopa and dopamine agonists. Animal models aim to reproduce the features of Parkinson's through pharmacological or genetic means to better understand and research the disease.
Parkinson's Disease, SYMPTOMS OF PARKINSONISM, STAGES OF PARKINSONISM, ETIOLOGY OF PARKINSONISM, PATHOPHYSIOLOGY OF PARKINSONISM, TREATMENT OF PARKINSONISM.
This document provides an overview of Parkinson's disease. It begins with an introduction describing Parkinson's as a progressive neurological disease caused by the death of dopamine-producing neurons in the substantia nigra. It then covers the history, epidemiology, signs and symptoms, management including medications and surgery, and nursing considerations for patients with Parkinson's disease. The document aims to give a comprehensive yet concise description of Parkinson's for healthcare professionals.
PARKINSON'S DISEASE And pathophysiology .pdf by SMH.pdfwajidullah9551
Parkinson's disease is a progressive neurological disorder caused by the loss of dopamine-producing neurons in the brain. It is characterized by tremors, rigidity, slow movement, and impaired balance. While there is no cure, treatment aims to manage symptoms through medications like levodopa and deep brain stimulation. Nurses focus on assessing symptoms, educating patients and families, and ensuring optimal management of this chronic condition.
This document provides an overview of Parkinson's disease, including its symptoms, stages of progression, causes, risk factors, diagnosis, and treatment options. Parkinson's is a progressive neurological disorder that results from the loss of dopamine-producing cells in the brain. Its primary symptoms are tremors, rigidity, bradykinesia, and postural instability. While there is no cure, treatments can help manage symptoms and maintain quality of life, such as medication to increase dopamine levels, surgery, physiotherapy, and deep brain stimulation.
parkinson's disease by me ..........prakash mahala p.g. medical surgical nursing at himalayan college of nursing dehradun.......prakashjpmmahala@gmail.com
This document discusses Parkinson's disease, including its definition, signs and symptoms, causes, pathophysiology, diagnosis, treatment, and nursing management. Parkinson's is a progressive nervous system disorder that causes movement issues like tremors and rigidity. It results from the loss of dopamine-producing neurons in the brain. While the exact cause is unknown, risk factors include age, genetics, and environmental toxins. Treatment focuses on increasing dopamine levels through medications or surgery. Nurses help manage symptoms, monitor for complications, and promote independence and safety.
TY BSc PAPER -5 Drugs & Dyes , Unit-2 Chapter : Anti-Parkinsonism drugs pravin bendle
1) Parkinson's disease is caused by depletion of dopamine in the brain and results in symptoms like tremors, rigidity, slow movement, and issues with posture, speech, and swallowing.
2) Anti-Parkinsonism drugs work by antagonizing neurotransmitters to block the origin of tremors and other symptoms. The main classes are anticholinergic agents and dopaminergic agents.
3) Levodopa is the most commonly used drug, as it can cross the blood brain barrier and be converted to dopamine to replace the depleted levels in Parkinson's patients. It is synthesized from vanillin and glycine in several steps.
Parkinson's disease is a degenerative disorder of the central nervous system that affects movement. It occurs when nerve cells in the brain do not produce enough dopamine. The document outlines the symptoms, stages, causes, treatment, and animal models of Parkinson's disease. The main symptoms are motor symptoms like tremors and rigidity as well as non-motor symptoms like mood changes. Treatment focuses on replacing dopamine and managing symptoms, primarily using levodopa and dopamine agonists. Animal models aim to reproduce the features of Parkinson's through pharmacological or genetic means to better understand and research the disease.
Parkinson's Disease, SYMPTOMS OF PARKINSONISM, STAGES OF PARKINSONISM, ETIOLOGY OF PARKINSONISM, PATHOPHYSIOLOGY OF PARKINSONISM, TREATMENT OF PARKINSONISM.
Parkinson's disease is a progressive neurodegenerative disorder that affects movement, muscle control and balance. It results from depletion of the neurotransmitter dopamine in the brain. The three main types are defined by age of onset - adult, young-onset and juvenile. Symptoms include tremors, rigidity, slow movement and impaired balance. Diagnosis is based on symptoms and neurological exam, with no specific tests. Treatment focuses on controlling symptoms through medications and lifestyle changes, with deep brain stimulation or surgery as options for some patients. Complications can include difficulty with daily living, swallowing, disability, falls and medication side effects.
This document provides an overview of Parkinson's disease. It begins with definitions and discusses epidemiology, etiology, risk factors, types, signs and symptoms, pathophysiology, staging, complications, diagnosis, and pharmacotherapy. The key points are:
- Parkinson's disease is a progressive neurodegenerative disorder caused by loss of dopamine-producing neurons in the substantia nigra.
- Risk increases with age and family history. Symptoms include tremors, rigidity, bradykinesia, and postural instability.
- Diagnosis is based on symptoms and response to levodopa treatment. Staging uses the Hoehn and Yahr scale.
- Treatment focuses on dopamine replacement therapy
During my 1st &2nd year of residency period , i used to teach Anatomy and Orthopaedics for foreign undergraduate medical students. At last year i taught Neurology for one batch. so i posted some of my collections for competely educational purpose coz i believe in knowledge ...inseted of deleting these ppts , they may me useful for others so i shared it ....
Advances in Management of Parkinson's DiseaseSultana Shaikh
Parkinson's disease [PD] is one of the most common neurodegenerative disorders. There have been significant recent advances in the understanding of the pathogenesis of the disease. There has also been a greater realization that the disorder may be associated with significant non-motor disturbances in addition to the more commonly recognized motor complications. There are many drugs like levodopa and carbidopa, ropinirole, pramipexole, rotigotine etc. and some MAO-B INHIBITOR like selegiline and rasagiline which are used in treatment of Parkinson’s disease. Some COMT INHIBITOR
and others drugs are also available and some herbs like turmeric, ginger, garlic etc. provides temporary relief from Parkinson’s disease. There are two vaccines which are under development for the treatment of Parkinson’s disease.
1. Parkinson's disease is a progressive neurodegenerative disorder that causes movement abnormalities like tremors and rigidity due to the loss of dopamine-producing neurons in the substantia nigra.
2. Levodopa is the most effective treatment for motor symptoms but its effectiveness reduces over time and side effects like dyskinesia emerge.
3. Deep brain stimulation (DBS) is an alternative treatment that involves implanting electrodes in the brain to deliver electrical stimulation to areas affected by Parkinson's and help control motor symptoms.
This document discusses Parkinson's disease and related conditions. It begins with an overview of the brain and neuronal transmission. It then defines Parkinsonism and distinguishes it from Parkinson's disease. The document discusses the diagnosis and treatment of Parkinson's disease as well as Parkinson-plus syndromes. It provides clinical clues to differentiate various conditions and discusses their treatment approaches. The document concludes with key points and references.
Parkinson disease is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms. It is caused by the loss of dopamine-producing neurons in the brain and affects millions worldwide. The symptoms were first described in 1817 and include tremors, stiffness, slow movement, and impaired balance and coordination. While its progression cannot be stopped, symptoms can be effectively treated with dopamine replacement therapy such as levodopa. Advanced disease brings new challenges of managing motor fluctuations between periods of good control and poor control.
Parkinson's disease is a progressive nervous system disorder that causes a loss of dopamine-producing brain cells, leading to motor symptoms like tremors and rigidity. It occurs due to degeneration of the substantia nigra, decreasing dopamine levels in the basal ganglia. The document discusses the causes, symptoms, diagnosis, treatment and management of Parkinson's disease with a focus on increasing dopamine levels through drugs like L-DOPA, COMT inhibitors, and dopamine receptor agonists.
Parkinsonism is a progressive neurological disorder characterized by bradykinesia, muscular rigidity, resting tremor, and impaired balance. It can be caused by idiopathic Parkinson's disease, vascular issues, certain drugs that block dopamine, or dementia with Lewy bodies. Treatment aims to increase dopamine in the brain and involves levodopa, dopamine agonists, MAO inhibitors, COMT inhibitors, amantadine, and anticholinergic drugs.
Parkinson's disease is the second most common degenerative disease of the central nervous system. It typically occurs in older adults around age 60 and is more common in males. The disease is characterized by degeneration of dopamine-producing neurons in the brain and presence of Lewy bodies. The main symptoms include bradykinesia, resting tremor, and rigidity. Levodopa is the most effective treatment for motor symptoms, but its long term use can cause dyskinesia and other side effects. Deep brain stimulation is an effective surgical treatment for some patients. Overall, Parkinson's disease is a progressive neurodegenerative disorder involving the extrapyramidal system.
Parkinson's disease is a neurodegenerative disorder that affects movement. It is the second most common neurodegenerative disease after Alzheimer's disease. The main characteristics are loss of dopamine-producing neurons in the substantia nigra, which leads to motor symptoms like tremors, rigidity, and bradykinesia. While the exact causes are unknown, both genetic and environmental factors are thought to play a role. Treatment involves dopamine replacement therapy with levodopa and other drugs to manage motor and non-motor symptoms.
Parkinson's disease is a neurological disorder that results from the loss of dopamine-producing neurons in the substantia nigra region of the brain. This leads to a reduction in dopamine levels in the striatum, impairing motor control and producing symptoms like tremors, rigidity, and impaired balance. The disease is characterized by the aggregation and accumulation of the alpha-synuclein protein within neurons, which is thought to contribute to their degeneration over time. While the specific causes are unknown, genetic factors and environmental toxins are thought to increase the risk of developing the disease.
Parkinson's disease is a progressive disorder of the central nervous system that results from the loss of dopamine-producing neurons in the brain. The main symptoms are tremors, rigidity, and slowness of movement. While the exact causes are unknown, factors like genetics, environmental toxins, and aggregates of proteins in the brain have been linked to neuronal degeneration and Parkinson's disease.
Parkinson's disease is a progressive neurodegenerative disorder that results from the gradual loss of dopamine-producing neurons in the brain. This causes motor system impairments like tremors, stiffness, and slowed movement. The document discusses the stages of Parkinson's disease progression, common symptoms like tremors and slowed movement, current treatments focused on managing symptoms, and differences between Parkinson's and Alzheimer's diseases.
Parkinson's disease is a degenerative disorder of the central nervous system that mainly affects movement. It results from the loss of dopamine-producing neurons in the brain. The main symptoms are tremors at rest, slow movement, stiffness, and impaired balance and coordination. While the causes are mostly unknown, both genetic and environmental factors can play a role. There is no cure for Parkinson's disease but treatments can help manage the motor and non-motor symptoms.
This document provides an overview of Parkinson's disease including:
- It is a progressive neurodegenerative disorder caused by loss of dopaminergic neurons.
- There are three main types: primary, secondary, and Parkinsonism plus syndromes.
- Etiology includes both genetic and environmental factors.
- Secondary Parkinsonism has many potential causes including certain medications, infections, toxins, and other neurodegenerative conditions.
- Pathology involves degeneration in the substantia nigra leading to dopamine depletion in the striatum.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Parkinson's disease is a progressive neurodegenerative disorder that affects movement, muscle control and balance. It results from depletion of the neurotransmitter dopamine in the brain. The three main types are defined by age of onset - adult, young-onset and juvenile. Symptoms include tremors, rigidity, slow movement and impaired balance. Diagnosis is based on symptoms and neurological exam, with no specific tests. Treatment focuses on controlling symptoms through medications and lifestyle changes, with deep brain stimulation or surgery as options for some patients. Complications can include difficulty with daily living, swallowing, disability, falls and medication side effects.
This document provides an overview of Parkinson's disease. It begins with definitions and discusses epidemiology, etiology, risk factors, types, signs and symptoms, pathophysiology, staging, complications, diagnosis, and pharmacotherapy. The key points are:
- Parkinson's disease is a progressive neurodegenerative disorder caused by loss of dopamine-producing neurons in the substantia nigra.
- Risk increases with age and family history. Symptoms include tremors, rigidity, bradykinesia, and postural instability.
- Diagnosis is based on symptoms and response to levodopa treatment. Staging uses the Hoehn and Yahr scale.
- Treatment focuses on dopamine replacement therapy
During my 1st &2nd year of residency period , i used to teach Anatomy and Orthopaedics for foreign undergraduate medical students. At last year i taught Neurology for one batch. so i posted some of my collections for competely educational purpose coz i believe in knowledge ...inseted of deleting these ppts , they may me useful for others so i shared it ....
Advances in Management of Parkinson's DiseaseSultana Shaikh
Parkinson's disease [PD] is one of the most common neurodegenerative disorders. There have been significant recent advances in the understanding of the pathogenesis of the disease. There has also been a greater realization that the disorder may be associated with significant non-motor disturbances in addition to the more commonly recognized motor complications. There are many drugs like levodopa and carbidopa, ropinirole, pramipexole, rotigotine etc. and some MAO-B INHIBITOR like selegiline and rasagiline which are used in treatment of Parkinson’s disease. Some COMT INHIBITOR
and others drugs are also available and some herbs like turmeric, ginger, garlic etc. provides temporary relief from Parkinson’s disease. There are two vaccines which are under development for the treatment of Parkinson’s disease.
1. Parkinson's disease is a progressive neurodegenerative disorder that causes movement abnormalities like tremors and rigidity due to the loss of dopamine-producing neurons in the substantia nigra.
2. Levodopa is the most effective treatment for motor symptoms but its effectiveness reduces over time and side effects like dyskinesia emerge.
3. Deep brain stimulation (DBS) is an alternative treatment that involves implanting electrodes in the brain to deliver electrical stimulation to areas affected by Parkinson's and help control motor symptoms.
This document discusses Parkinson's disease and related conditions. It begins with an overview of the brain and neuronal transmission. It then defines Parkinsonism and distinguishes it from Parkinson's disease. The document discusses the diagnosis and treatment of Parkinson's disease as well as Parkinson-plus syndromes. It provides clinical clues to differentiate various conditions and discusses their treatment approaches. The document concludes with key points and references.
Parkinson disease is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms. It is caused by the loss of dopamine-producing neurons in the brain and affects millions worldwide. The symptoms were first described in 1817 and include tremors, stiffness, slow movement, and impaired balance and coordination. While its progression cannot be stopped, symptoms can be effectively treated with dopamine replacement therapy such as levodopa. Advanced disease brings new challenges of managing motor fluctuations between periods of good control and poor control.
Parkinson's disease is a progressive nervous system disorder that causes a loss of dopamine-producing brain cells, leading to motor symptoms like tremors and rigidity. It occurs due to degeneration of the substantia nigra, decreasing dopamine levels in the basal ganglia. The document discusses the causes, symptoms, diagnosis, treatment and management of Parkinson's disease with a focus on increasing dopamine levels through drugs like L-DOPA, COMT inhibitors, and dopamine receptor agonists.
Parkinsonism is a progressive neurological disorder characterized by bradykinesia, muscular rigidity, resting tremor, and impaired balance. It can be caused by idiopathic Parkinson's disease, vascular issues, certain drugs that block dopamine, or dementia with Lewy bodies. Treatment aims to increase dopamine in the brain and involves levodopa, dopamine agonists, MAO inhibitors, COMT inhibitors, amantadine, and anticholinergic drugs.
Parkinson's disease is the second most common degenerative disease of the central nervous system. It typically occurs in older adults around age 60 and is more common in males. The disease is characterized by degeneration of dopamine-producing neurons in the brain and presence of Lewy bodies. The main symptoms include bradykinesia, resting tremor, and rigidity. Levodopa is the most effective treatment for motor symptoms, but its long term use can cause dyskinesia and other side effects. Deep brain stimulation is an effective surgical treatment for some patients. Overall, Parkinson's disease is a progressive neurodegenerative disorder involving the extrapyramidal system.
Parkinson's disease is a neurodegenerative disorder that affects movement. It is the second most common neurodegenerative disease after Alzheimer's disease. The main characteristics are loss of dopamine-producing neurons in the substantia nigra, which leads to motor symptoms like tremors, rigidity, and bradykinesia. While the exact causes are unknown, both genetic and environmental factors are thought to play a role. Treatment involves dopamine replacement therapy with levodopa and other drugs to manage motor and non-motor symptoms.
Parkinson's disease is a neurological disorder that results from the loss of dopamine-producing neurons in the substantia nigra region of the brain. This leads to a reduction in dopamine levels in the striatum, impairing motor control and producing symptoms like tremors, rigidity, and impaired balance. The disease is characterized by the aggregation and accumulation of the alpha-synuclein protein within neurons, which is thought to contribute to their degeneration over time. While the specific causes are unknown, genetic factors and environmental toxins are thought to increase the risk of developing the disease.
Parkinson's disease is a progressive disorder of the central nervous system that results from the loss of dopamine-producing neurons in the brain. The main symptoms are tremors, rigidity, and slowness of movement. While the exact causes are unknown, factors like genetics, environmental toxins, and aggregates of proteins in the brain have been linked to neuronal degeneration and Parkinson's disease.
Parkinson's disease is a progressive neurodegenerative disorder that results from the gradual loss of dopamine-producing neurons in the brain. This causes motor system impairments like tremors, stiffness, and slowed movement. The document discusses the stages of Parkinson's disease progression, common symptoms like tremors and slowed movement, current treatments focused on managing symptoms, and differences between Parkinson's and Alzheimer's diseases.
Parkinson's disease is a degenerative disorder of the central nervous system that mainly affects movement. It results from the loss of dopamine-producing neurons in the brain. The main symptoms are tremors at rest, slow movement, stiffness, and impaired balance and coordination. While the causes are mostly unknown, both genetic and environmental factors can play a role. There is no cure for Parkinson's disease but treatments can help manage the motor and non-motor symptoms.
This document provides an overview of Parkinson's disease including:
- It is a progressive neurodegenerative disorder caused by loss of dopaminergic neurons.
- There are three main types: primary, secondary, and Parkinsonism plus syndromes.
- Etiology includes both genetic and environmental factors.
- Secondary Parkinsonism has many potential causes including certain medications, infections, toxins, and other neurodegenerative conditions.
- Pathology involves degeneration in the substantia nigra leading to dopamine depletion in the striatum.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
10 Benefits an EPCR Software should Bring to EMS Organizations Traumasoft LLC
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
3. INTRODUCTION:
Parkinson disease is a slowly progressive , chronic
neurological disease that effects a small area of nerve cells in
an area of the brain known as the substantia nigra.
This cells normally produces dopamine, a chemical
(neurotransmission) that transmits signal between areas in the
brain that when working normally coordinates smooth and
balanced muscle movement .
Parkinson’s disease cause this nerve cells to die and as a result
body movement are effected.
4. HISTORYOF PD:
In 1817, a detailed medical essay was published on the
subject by London doctor, Dr. James Parkinson.
Jean Martin Charcot was the first to truly recognize the
importance of Dr. James Parkinson’s and renamed the
disease after him as ‘’Parkinson’s disease’’ which was
formerly named paralysis agitation (shaking palsy).
5. EPIDEMIOLOGY:
Parkinson disease occurs worldwide and is present in all races.
Males are more affected than females.
Prevention of Parkinson disease increase with increasing age of 1% of person
from age 60.
YOPD starts between 21 -40 years of age affecting 5 to 10% of Parkinson
disease patients.
China is the country world largest prevalence of Parkinson disease.
The incidence and prevalence of Parkinson disease in India is lesser as
compared to other country, Rural population had a higher prevalence than
urban population 41:14.
6. DEFINITION:
Parkinson disease is characterized by
tremor at rest, rigidity and slowness
or difficulty in initiating and
executing movement (Akinesis or
Bradykinesis). This combination of
clinical features is collectively known
as Parkinsonism.
Parkinsonism is a syndrome with
numerous cause of which Parkinson
disease is the most common.
8. The substantia nirga is a nucleus in the mid brain which is part of the Basal
Ganglia.
The substantia nigra is made up of two automatically and functionally distinct
portion :
Substantia nigra pars compacta –more darkened
Substantia Nigra pars reticulata –less darken.
Most of the dopamine neuron of the brain originate in the midbrain and are
found in either the substantia Nigra.
The Dopamine neurons in the substantia Nigra express high level of pigment
called Neuromelanin which accounts for thin dark colour .
The substantia Nigra par compacta contain more dopamine neurons while pars
Reticulate contains more GABA neurons .
9. CLINICAL SIGNIFICANCE:
Parkinson disease is associated with the
death of dopamine Neuron in the
substantia Nigra pars compacta which is
due to neuro-degeneration .
when a significant number of this neuron
have died, the individual will likely to
start to experienced movement –related
problems like tremors, rigidity, slowness
of movement and postural instability –
which are the hall mark symptoms of
Parkinson disease.
10. ETIOLOGY/RISK FACTORS:
Advancing age : Above 60 years mostly seen while young onset Parkinson disease
is called a patients develop Parkinson disease between 21-40 years.
Sex: male are more likely to get than female.
Family History: Having one or more close relatives with the disease increase the
rise of getting.
Low Estrogen Level: most menopausal women who don’t use hormone
replacement therapy are more risk of getting the disease.
Agricultural work: exposure to environmental toxin such as pesticide ,herbicides
,inhabits dopamine production and promote free radical damage. these involved
in farming and are exposed to such toxins have a greater risk of getting the
disease.
Low level of vitamins: researchers de was found that people with low level of
vitamin B develop severe Parkinson symptoms.
Head Trauma: Trauma to the head ,neck and upper cervical spine increase the
chance of getting Parkinson’s.
11. Genetic Mutation: people who have both young onset Parkinson’s disease and a
strong family history of the disease are more likely carry genes linked to
Parkinson’s disease which includes;
Alpha Synuclein: Autosomal dominant.
LRRK2(leucine rich repeat kinesis2): Autosomal.
PINK1/PARKIN/DJ-1: Autosomal recessive
GBA(Glucocerebrocidase): Autosomal recessive
Alpha synuclein and LRRK2 gene mutation is linked with Young onset Parkinson
Disease.
12. Other causes:
Secondary Parkinson’s: which are caused by other disorders such as
Neoplasm, multiple cerebral infarction and infection of the brain.
Drug induces Parkinsonism: which are irreversible. causative drugs
include : Neuroleptics – haloperidol ,risperidone, olanzapine.
Antiemetic- metachlopramine, prochlorperazine.
Parkinson’s disease caused by Degenerative disease in which
symptoms of Parkinson’s disease are combines with neurologic deficit
yet patients fail to response to Anti-Parkinson drugs therapy . These
disorders include
Multiple system atrophy (MSA).
Alzheimer’s Disease -often accompanied with mild signs of
Parkinsonism.
13. PATHOPHYSIOLOGY:
Etiological Factors:
Environmental
factors
Gene mutation
Degenerative
disease
Destruction of Dopaminergic neuronal cells in the substantia nigra in the
basal Ganglia
Neuronal cells loss and depigmentation
Degeneration of dopaminergic activity particularly in the nigro-striatal
pathway
Depletion of dopamine store
Imbalance between excitatory (Acetylcholine) and inhibiting
(dopamine) neurotransmitter in the corpus striation
Impairment of extrapyramidal tract controlling
complex body movement
Tremors
Rigidity
Akinesis
Postural instability
14. SIGNS AND SYMPTOMS:
Four cardinal sign:
Resting tremor
Rigidity
Akinesia
Postural instability
Cog-wheeling
AKINESIA:
Bradykinesia
Hypokinesia
Hypophonia
Micrographia
DYSAUTONOMIA: it includes
sweats,facial flushing.
Dyspnea, urinary frequency, urgency.
GI dysfunction-constipation.
Dysphagia
Orthostatic hypotension and sexual
dysfunction
Cognitive And psychiatric disturbance:
Anxiety, Apathy, mental, irritability,
impaired executive function, depression
psychosis (delusions and Italicization)
dementia
POSTURAL DISTURBANCE:
Stooped or fixed positive
Disequilibrium or postural
instability
Retropulsion –backward
motion
Propulsion – forward motion
Sleep disturbance:
Frequent awakening
Daytimes sleepiness’
Sensory impairment:
pain, restlessness and
Akathisia.
15. STAGES OF PARKINSON’s DISEASE
Parkinson’s disease is typically classified by the worsenng of clinical
manifestation. The modified Hoehn and yohr and scale is one method use to
rate the severity of Parkinson’s disease.
STAGE 0: No evidence of Parkinson’s disease.
Stage 1: Unilateral involvement .
Stage 1.5: Unilateral and Axial involvement .
Stage 2: Bilateral involvement, balance in contact .
Stage 2.5: Bilateral involvement, recovery on pull test .
Stage 3: Mild to moderate impairment with postural instability .
Stage 4: Severe impairment but still able to stand or walk un assisted.
Stages 5: Confinement to a wheel chair or bed .
16. DIAGNOSTIC EVALUATION:
Laboratory test and imaging studies are not helpful in the diagnosis of
Parkinson’s disease.
Criteria for making diagnosis of Parkinson’s disease include the
following
1. Through patients’ history and performed complete neurological
examination.
2. CT scan or MRI of head to rule out secondary cause.
3. PET-scan to evaluate levodopa uptake and conversion to Dopamine in
the corpus Striatum .
4. Present of two or more cardinal features (resting tremors, rigidity,
Akinesia, postural instability).
5.Final diagnosis usually made by the pressure of heavy bodies in the
brain during Autopsy.
17. MANAGEMENT:
There are complete cure for Parkinson’s disease.
Treatment is directed at controlling symptoms and maintaining
functional independence.
There are no medical or surgical approaches that prevent
disease progression.
Care is individualized for each patients based on preventing
symptoms and social occupational and social needs.
Pharmacologic management is the main stay of treatment.
18. ANTI-PARKINSONISM MEDICATION:
1. LEVEDOPA (L-Dopa): it is the most effective agents and the mainstay of treatment, for
controlling the symptoms particularly Bradykinesia and rigidity.
SINEMET: it is made up of Levodopa and carbidopa .Levodopa enters the brain and is
converted to Dopamine while carbidopa increase its effectiveness and prevents the side
effects of levodopa such as nausea, vomiting.
2. DOPAMINE RECEPTOR AGONISTS: this are the drugs that activate or stimulate the
dopamine receptors . They mimic or copy the function of Dopamine in the brain. Dopamine
agonists can be taken alone or in combination with Levodopa/carbidopa. Most commonly
drugs used are
Ergot derivatives : Bromocriptine or pergolite.
Non-ergot Derivatives: Ropinirole ,pramipexole.
3. MONOAMINE OXIDIZED INHIBITORS: It blocks an enzymes that caused premature of
levodopa and are used primarily to treat motors fluctuation associated with levodopa
treatment .most commonly drugs used are
Seligiline
Rosagiline.
19. AMANTADINE : it is the most commonly used medication for early onset Parkinson’s
disease to tract tremor .It reduce dyskinesia’s that occur with Levodopa.
COMT INHIBITORS(Catechol-o-methyl-transferase): such is Tolcapone and entacapone
response the newest class of Parkinson’s drugs .
It does not have direct effect on Parkinson’s disease symptoms
it prolong the effect of levodopa by blocking its metabolism.
ANTI-CHOLINERGIC: it is helpful in controlling tremors and rigidity.
It decrease the activity of acetylcholine, a neurotransmitter that regulates
movement ,most commonly used are:
Benzotropine mesylate
Trihexyphenidyl HCL
ANTI-DEPRESSANT :
Amitriptyline is typically prescribe because of its Anticholinergic and
Antidepressant effect.
Serotonins reuptake inhibitors; Fluoxetine Hydrochloride and Bupropion
hydrochloride.
Effective for treating depression in patients with Parkinson’s disease.
20. SURGICAL MANAGEMENT:
THALATOMY:
It involves destruction of part of the Thalamus,
generally the ventral’s intermediates (VIM) to
relieve tremor.
The VIM nucleus is considered the best target for
tremor suppression with excellent short and long
term tremor suppression in 80-90% of patients
with Parkinson’s diseases.
When rigidity and Akinesia are prominent other
targets ,deep brain stimulation of both Globus
pallidus interna (Gpi) and subthalami nucleus
(STN)are preferred.
21. PALLIDOTOMY:
Pallidotomy is a neurosurgical
procedure whereby a tiny electrical
probe is placed in the globes pallidus,
which is then heated to 800C for 60
sec, to destroy a small area of brain
cells.
It is effective for treating in
voluntary movements known as
Dyskinesia, motor symptoms
presented with Parkinson’s Disease.
22. DEEP BRAIN STIMULATION:
Deep brain stimulation is a neurological procedure
which was first approved in 1997 to treat Parkinson’s
diseases tremor, then in 2002 for treatment of
advanced Parkinson’s diseases symptoms.
More recently in 2016 DBS surgery was approved for
the earlier stages of Parkinson’s for those with at least
four years disease duration with motors complication
that are not controlled with medications.
Deep brain stimulation involves the implantation of
permanents thin electrodes into selected deep parts
of the brain .
The targets area of the brain depends on the
presenting symptoms, the most common targets area
are thalamus, subthalamic nucleus(STN)and Globus
pallidus in terna(Gpi).
23. NURSING MANAGEMENT:
Nursing Assessment:
Obtain a history of symptoms and their effect on functioning,
mobility, feeding, communication, and self-care difficulties.
Assess cranial nerves, cerebellar function (co-ordination) and
motor function.
Observe gait and performance of activities
Assess speech for clarity and space
Assess for sign of depression
Assess family supports and access to social service.
24. Nursing Diagnosis:
1. Impaired physical mobility related to Bradykinesia,
rigidity and tremors
2. Imbalance nutrition less than body requirement related
to motor difficulties with feeding, chewing and swallowing
3. Impaired verbal communication related to decreased
speech volume
4. Constipation related to diminished motor function and
inactivity
5. Ineffective coping related to physical limitation and loss
of independence.
25.
26. CONCLUSION:
Parkinson’s disease is a chronic, progressive neurologic disorders that results
from the loss of the neurotransmitter dopamine in a group of brain structures
that controls movement.
The cardinal symptoms are resting tremors, rigidity, Akinesia and postural
instability.
The goal of management is to control the manifestation such as motor and
non-motor symptoms with the lowest possible dose of medication in order to
avoid side effects.
Medication selection and dosage depend on the manifestation, age of the
client and presence of other medical condition.
Nursing care should focus on the health assessment, medication instruction
and monitoring, liaison with other members of the health care team, and
family members and family education.