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Rajkot Press meeting to launch the campaign : "Conquering Parkinson's Disease"- We will not be defeated
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Parkinsonism
Parkinsonism is a neurological syndrome characterized by tremors, slowed movement, rigidity, and impaired posture and balance. It is caused by degeneration of dopamine-producing neurons in the substantia nigra region of the brain. Parkinsonism occurs in Parkinson's disease but can be caused by other neurological conditions and toxins as well. Symptoms are treated with levodopa/carbidopa to increase dopamine levels or dopamine agonists, though these drugs can cause side effects like nausea, dizziness, and hallucinations. Diagnosis involves neurological exams and tests like MRI and bloodwork to evaluate motor and non-motor symptoms.
Coma Arousal Therapy
Presentation during IFNR 2016.
Brief description with available evidence on various coma arousal therapy with an illustrative study for each therapy and recommendation for future.
Treatment of parkinson’s disease
This document provides information on the diagnosis and treatment of Parkinson's disease. It begins with disclosures and objectives. It then describes the symptoms of Parkinson's disease and differentiates between Parkinson's disease and Parkinson's syndromes. It outlines various conditions that can mimic Parkinson's disease symptoms. The document discusses investigations that can be done for diagnosis and lists various medications used in treating Parkinson's disease, including levodopa, COMT inhibitors, dopamine agonists, MAO-B inhibitors, and others. It provides guidance on initiating and discontinuing medications. An example case is presented and treatment approach described.
Hanipsych, novel antipsychotics
This document provides an update on antipsychotic medications from Prof. Hani Hamed Dessoki. It discusses oral and long-acting injectable second-generation antipsychotics (SGAs) including two new products, Vraylar and Nuplazid. It also mentions guidelines for antipsychotic use in dementia and a new boxed warning for olanzapine regarding DRESS syndrome. Product and guideline updates are provided at the end.
Headache – practical scenario
This document discusses several key points about managing headaches and migraines:
- It describes a case of a 24-year-old woman experiencing episodic vertigo and asks what additional information would be useful to obtain.
- It then reviews treatment options for migraine-related vertigo and indicates that cinnarizine would be an appropriate initial treatment.
- Finally, it discusses the use of flunarizine for migraine prophylaxis, including its indications, contraindications, adverse effects, interactions, and evidence from clinical studies supporting its effectiveness in reducing migraine frequency and severity.
Hanipsych, novel antidep.
Major depressive disorder affects around 300 million individuals worldwide and is a significant public health concern. While SSRIs are usually first-line treatment, many patients do not respond or have intolerable side effects. Novel antidepressants target multiple neurotransmitter systems and have improved efficacy and tolerability profiles. Vilazodone, vortioxetine, and levomilnacipran are newer antidepressants approved for treatment of MDD. Ketamine, psilocybin, and transcranial magnetic stimulation show promise but require more research before being widely adopted.
New Trends in Epilepsy Management
On the occasion of National Epilepsy Day 2014, Dr. V Natarajan gave a talk titled "New Trends in Epilepsy Management" at the Epilepsy Knowledge Forum in Chennai organised by Neurokrish & Trimed and Sponsored Medall.
Headache
Headaches can be caused by many factors and require evaluation to determine the cause. Sudden, severe headaches require prompt evaluation to rule out serious underlying issues. Migraines typically involve throbbing pain and associated symptoms like nausea while tension headaches feel like pressure across the entire head. Treatment depends on the identified cause but may include medications, lifestyle changes, and reassurance when risks of serious conditions are low.
Recommended
Parkinsonism
Parkinsonism is a neurological syndrome characterized by tremors, slowed movement, rigidity, and impaired posture and balance. It is caused by degeneration of dopamine-producing neurons in the substantia nigra region of the brain. Parkinsonism occurs in Parkinson's disease but can be caused by other neurological conditions and toxins as well. Symptoms are treated with levodopa/carbidopa to increase dopamine levels or dopamine agonists, though these drugs can cause side effects like nausea, dizziness, and hallucinations. Diagnosis involves neurological exams and tests like MRI and bloodwork to evaluate motor and non-motor symptoms.
Coma Arousal Therapy
Presentation during IFNR 2016.
Brief description with available evidence on various coma arousal therapy with an illustrative study for each therapy and recommendation for future.
Treatment of parkinson’s disease
This document provides information on the diagnosis and treatment of Parkinson's disease. It begins with disclosures and objectives. It then describes the symptoms of Parkinson's disease and differentiates between Parkinson's disease and Parkinson's syndromes. It outlines various conditions that can mimic Parkinson's disease symptoms. The document discusses investigations that can be done for diagnosis and lists various medications used in treating Parkinson's disease, including levodopa, COMT inhibitors, dopamine agonists, MAO-B inhibitors, and others. It provides guidance on initiating and discontinuing medications. An example case is presented and treatment approach described.
Hanipsych, novel antipsychotics
This document provides an update on antipsychotic medications from Prof. Hani Hamed Dessoki. It discusses oral and long-acting injectable second-generation antipsychotics (SGAs) including two new products, Vraylar and Nuplazid. It also mentions guidelines for antipsychotic use in dementia and a new boxed warning for olanzapine regarding DRESS syndrome. Product and guideline updates are provided at the end.
Headache – practical scenario
This document discusses several key points about managing headaches and migraines:
- It describes a case of a 24-year-old woman experiencing episodic vertigo and asks what additional information would be useful to obtain.
- It then reviews treatment options for migraine-related vertigo and indicates that cinnarizine would be an appropriate initial treatment.
- Finally, it discusses the use of flunarizine for migraine prophylaxis, including its indications, contraindications, adverse effects, interactions, and evidence from clinical studies supporting its effectiveness in reducing migraine frequency and severity.
Hanipsych, novel antidep.
Major depressive disorder affects around 300 million individuals worldwide and is a significant public health concern. While SSRIs are usually first-line treatment, many patients do not respond or have intolerable side effects. Novel antidepressants target multiple neurotransmitter systems and have improved efficacy and tolerability profiles. Vilazodone, vortioxetine, and levomilnacipran are newer antidepressants approved for treatment of MDD. Ketamine, psilocybin, and transcranial magnetic stimulation show promise but require more research before being widely adopted.
New Trends in Epilepsy Management
On the occasion of National Epilepsy Day 2014, Dr. V Natarajan gave a talk titled "New Trends in Epilepsy Management" at the Epilepsy Knowledge Forum in Chennai organised by Neurokrish & Trimed and Sponsored Medall.
Headache
Headaches can be caused by many factors and require evaluation to determine the cause. Sudden, severe headaches require prompt evaluation to rule out serious underlying issues. Migraines typically involve throbbing pain and associated symptoms like nausea while tension headaches feel like pressure across the entire head. Treatment depends on the identified cause but may include medications, lifestyle changes, and reassurance when risks of serious conditions are low.
Management of early and advanced parkinson disease
This document provides guidance on the management of Parkinson's disease (PD), including:
1) When to start drug therapy for early PD based on symptom severity and impact on daily life.
2) Guidelines for choosing initial therapy based on symptom dominance and severity, including levodopa, dopamine agonists, MAO-B inhibitors, and amantadine.
3) Management of motor complications including wearing off, dyskinesia, fluctuations, and non-motor symptoms.
4) Discussion of advanced therapies like deep brain stimulation, continuous levodopa infusion, and considerations for device selection.
Schizophrenia (MEDICAL MANAGEMENT
The primary treatment for schizophrenia is psychopharmacology. Antipsychotic medications, also known as neuroleptics, are prescribed to decrease psychotic symptoms. Conventional antipsychotics target positive symptoms like delusions and hallucinations by blocking dopamine, while atypical antipsychotics also target negative symptoms by blocking serotonin. Common side effects of antipsychotics include extrapyramidal symptoms like dystonia, akathisia, and tardive dyskinesia. Clozapine is effective but carries the risk of the potentially fatal agranulocytosis if white blood cell counts are not regularly monitored. Long-acting injectable forms of fluphenazine and haloperidol can be used for maintenance therapy
Pharmacological management of depression
This document provides an overview of the pharmacological management of depression. It discusses general considerations for antidepressant treatment, types of antidepressants including SSRIs, SNRIs, TCAs and others. It covers treating refractory depression, antidepressant use in special populations like children/adolescents and during pregnancy, and a symptom-based approach. Key points include recommending SSRIs as first-line treatment for moderate-severe depression and continuing medication for 6-9 months after symptom resolution to prevent relapse.
Approach to pharmacological treatment of epilepsy
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Zonisamide in parkinsons disease
This presentation reviews the current evidence favoring the use of Zonisamide in Idiopathic Parkinson disease
Migraine
Dr. Shafi Ullah Khan presents information on migraine including diagnostic criteria, clinical features, classification, pathophysiology, treatment approaches, and future treatment options. Key points include the diagnostic criteria of recurrent headache lasting 4-72 hours with features of nausea/vomiting/photophobia, classification into types such as migraine with and without aura, the trigeminovascular system pathway in migraine pathophysiology, treatment approaches including abortive medications and preventive medications/procedures, and novel emerging treatments under investigation.
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Neurological disorders and sleep
Description of sleep disorders in neurological diseases like epilepsy, dementia, ALS, parkinsonism and headaches
Status Epilepticus
Status epilepticus is defined as continuous seizure activity lasting more than 5 minutes or multiple seizures without recovery between seizures. It can become refractory or super-refractory if seizures continue despite treatment. The pathophysiology involves failure of endogenous mechanisms to terminate seizures, leading to a self-sustaining state through receptor trafficking and gene expression changes. Prolonged seizures cause neuronal injury and death. Poor prognosis factors include older age, longer duration of status epilepticus, lack of prior seizures, lower Glasgow Coma Scale, and acute symptomatic etiology.
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This document discusses sedation in the intensive care unit (ICU). It outlines the aims of sedation as keeping patients comfortable and pain free while minimizing anxiety and allowing cooperation with care. It discusses subjective and objective assessment of sedation and outlines therapies for analgesia and sedation including non-pharmacological and pharmacological options. Benefits and risks of over and under sedation are presented. Different sedative agents are compared and factors in selecting an agent are outlined.
Hanipsych, novel anti psychotics
Aripiprazole is a novel antipsychotic that acts as a partial agonist at dopamine D2 and serotonin 5-HT1A receptors and as an antagonist at 5-HT2A receptors. This combination of actions helps stabilize dopamine neurotransmission and provides benefits over previous antipsychotics. Studies show aripiprazole has efficacy against positive and negative symptoms with minimal risk of extrapyramidal side effects, prolactin elevation, weight gain, and long-term health consequences compared to other antipsychotics.
Migrane
Migraine is a common type of headache disorder characterized by recurrent headaches that can cause severe throbbing pain, nausea, vomiting, and sensitivity to light and sound. It is believed to involve changes in brain activity and inflammation of the blood vessels around the brain. Migraines can be further classified based on whether an "aura" occurs before the headache, as well as other associated neurological symptoms. Common triggers include hormonal changes, stress, foods, and environmental factors. Treatment involves managing acute attacks with over-the-counter or prescription medications as well as lifestyle changes and preventive medications to reduce frequency and severity of migraines.
Fm
a syndrome of persistent widespread pain, stiffness, fatigue, disrupted and unrefreshing sleep, and cognitive difficulties, often accompanied by multiple other unexplained symptoms, and functional impairment of activities of daily living.
Headache hkl
This document provides an overview of common types of headaches, including migraine, tension-type headache, cluster headache, and medication overuse headache. It discusses the signs, symptoms, diagnostic approach, and management strategies for each type. The diagnostic approach involves taking a thorough history, performing a physical examination, and ordering imaging tests only if indicated. Management involves both acute and preventative treatment depending on the headache type. The document emphasizes the importance of making an accurate diagnosis and reassuring patients that other pathology has been excluded.
Hedache classification migraine management neurologykota
This document discusses the classification and management of migraine headaches. It begins by outlining the International Classification of Headache Disorders criteria for classifying different types of migraines, including migraine without aura, migraine with aura, hemiplegic migraine, and chronic migraine. It then discusses the epidemiology, pathophysiology involving CGRP and other factors, and diagnostic criteria for some of the main migraine subtypes. The remainder of the document focuses on guidelines for managing acute migraines, preventing migraines, and treating refractory or chronic migraines, including in special populations like pregnancy and children. Treatment options discussed include triptans, CGRP antagonists, topiramate, valproate, and neurom
Unusual Headaches
The document discusses different types of headaches including:
1) Trigeminal autonomic cephalalgias which include cluster headache, paroxysmal hemicrania, and SUNCT/SUNA. Cluster headache is characterized by severe unilateral orbital or temporal pain lasting 15-180 minutes with associated autonomic symptoms.
2) Trigeminal neuralgia which causes sharp, stabbing pains in the face triggered by light touch in specific areas innervated by branches of the trigeminal nerve.
3) A case of cluster headache is then presented in more detail to illustrate the distinguishing features between cluster headache and other primary headache disorders.
Movement disorders emergencies
Movement disorders are not only realm of chronic disorders that are treated without requiring emergent intervention, but also they can present acutely with more aggressive forms
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My own slim attempt at covering the extremely complex and ever evolving field of migraine pathophysiology. Not intended by any means to be exhaustive but more like a unique take and beginner's guide.
Drug induced movement disorders
This document discusses drug-induced movement disorders caused by antipsychotic medications. It covers the classification of both acute and chronic movement disorders including dystonia, parkinsonism, akathisia, and tardive dyskinesia. It discusses the pathophysiology, risk factors, signs and symptoms, time of onset, scales used for assessment, management, and prevention of these medication-induced movement disorders. It also lists other medications that can cause movement disorders and the DSM-5 diagnostic categories for medication-induced movement disorders.
Approach to tremors
This document discusses the approach to tremors. It defines tremors and classifies them based on frequency, phenomenology, distribution, and etiology. Tremors can be rest tremors, action tremors such as postural tremors and kinetic tremors. Essential tremor is the most common cause of pathological tremor. Parkinson's disease causes rest tremors. Cerebellar tremors have a low frequency. Evaluation of tremors involves history, examination of affected body parts, tremor characteristics, and investigations like MRI and DAT scan to identify the underlying cause. Treatment depends on the cause but may include medications, botulinum toxin injections, or deep brain stimulation.
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This document provides guidance on the management of Parkinson's disease (PD), including:
1) When to start drug therapy for early PD based on symptom severity and impact on daily life.
2) Guidelines for choosing initial therapy based on symptom dominance and severity, including levodopa, dopamine agonists, MAO-B inhibitors, and amantadine.
3) Management of motor complications including wearing off, dyskinesia, fluctuations, and non-motor symptoms.
4) Discussion of advanced therapies like deep brain stimulation, continuous levodopa infusion, and considerations for device selection.
Schizophrenia (MEDICAL MANAGEMENT
The primary treatment for schizophrenia is psychopharmacology. Antipsychotic medications, also known as neuroleptics, are prescribed to decrease psychotic symptoms. Conventional antipsychotics target positive symptoms like delusions and hallucinations by blocking dopamine, while atypical antipsychotics also target negative symptoms by blocking serotonin. Common side effects of antipsychotics include extrapyramidal symptoms like dystonia, akathisia, and tardive dyskinesia. Clozapine is effective but carries the risk of the potentially fatal agranulocytosis if white blood cell counts are not regularly monitored. Long-acting injectable forms of fluphenazine and haloperidol can be used for maintenance therapy
Pharmacological management of depression
This document provides an overview of the pharmacological management of depression. It discusses general considerations for antidepressant treatment, types of antidepressants including SSRIs, SNRIs, TCAs and others. It covers treating refractory depression, antidepressant use in special populations like children/adolescents and during pregnancy, and a symptom-based approach. Key points include recommending SSRIs as first-line treatment for moderate-severe depression and continuing medication for 6-9 months after symptom resolution to prevent relapse.
Approach to pharmacological treatment of epilepsy
when and how to start medical treatment in epilepsy and how to manage afterward according to patient and drug characteristics
Zonisamide in parkinsons disease
This presentation reviews the current evidence favoring the use of Zonisamide in Idiopathic Parkinson disease
Migraine
Dr. Shafi Ullah Khan presents information on migraine including diagnostic criteria, clinical features, classification, pathophysiology, treatment approaches, and future treatment options. Key points include the diagnostic criteria of recurrent headache lasting 4-72 hours with features of nausea/vomiting/photophobia, classification into types such as migraine with and without aura, the trigeminovascular system pathway in migraine pathophysiology, treatment approaches including abortive medications and preventive medications/procedures, and novel emerging treatments under investigation.
Migraine pathophysiology, diagnosis and treatments
Introduction of migraine, including symptoms, epidemiology, pathophysiology(neurotransmitter, neural network, channel, CGRP), diagnostic criteria and treatment (oral, intravenous therapy at ED and long-term prevention)
Alemtuzumab (Lemtrada) in highly active multiple sclerosis
A brief case presentation of one of the first patients in India to be treated with Alemtuzumb (Lemtrada) for highly active Multiple Sclerosis.
Hanipsych, serotonine and depression
Serotonin plays an important role in regulating mitochondrial function and biogenesis in neurons through the 5-HT2A receptor. Stimulation of the 5-HT2A receptor activates the SIRT1-PGC-1α pathway, which are master regulators of mitochondrial biogenesis. This suggests serotonin signaling helps neurons adapt energetically and survive environmental challenges by increasing mitochondrial capacity.
Neurological disorders and sleep
Description of sleep disorders in neurological diseases like epilepsy, dementia, ALS, parkinsonism and headaches
Status Epilepticus
Status epilepticus is defined as continuous seizure activity lasting more than 5 minutes or multiple seizures without recovery between seizures. It can become refractory or super-refractory if seizures continue despite treatment. The pathophysiology involves failure of endogenous mechanisms to terminate seizures, leading to a self-sustaining state through receptor trafficking and gene expression changes. Prolonged seizures cause neuronal injury and death. Poor prognosis factors include older age, longer duration of status epilepticus, lack of prior seizures, lower Glasgow Coma Scale, and acute symptomatic etiology.
Sedation in icu
This document discusses sedation in the intensive care unit (ICU). It outlines the aims of sedation as keeping patients comfortable and pain free while minimizing anxiety and allowing cooperation with care. It discusses subjective and objective assessment of sedation and outlines therapies for analgesia and sedation including non-pharmacological and pharmacological options. Benefits and risks of over and under sedation are presented. Different sedative agents are compared and factors in selecting an agent are outlined.
Hanipsych, novel anti psychotics
Aripiprazole is a novel antipsychotic that acts as a partial agonist at dopamine D2 and serotonin 5-HT1A receptors and as an antagonist at 5-HT2A receptors. This combination of actions helps stabilize dopamine neurotransmission and provides benefits over previous antipsychotics. Studies show aripiprazole has efficacy against positive and negative symptoms with minimal risk of extrapyramidal side effects, prolactin elevation, weight gain, and long-term health consequences compared to other antipsychotics.
Migrane
Migraine is a common type of headache disorder characterized by recurrent headaches that can cause severe throbbing pain, nausea, vomiting, and sensitivity to light and sound. It is believed to involve changes in brain activity and inflammation of the blood vessels around the brain. Migraines can be further classified based on whether an "aura" occurs before the headache, as well as other associated neurological symptoms. Common triggers include hormonal changes, stress, foods, and environmental factors. Treatment involves managing acute attacks with over-the-counter or prescription medications as well as lifestyle changes and preventive medications to reduce frequency and severity of migraines.
Fm
a syndrome of persistent widespread pain, stiffness, fatigue, disrupted and unrefreshing sleep, and cognitive difficulties, often accompanied by multiple other unexplained symptoms, and functional impairment of activities of daily living.
Headache hkl
This document provides an overview of common types of headaches, including migraine, tension-type headache, cluster headache, and medication overuse headache. It discusses the signs, symptoms, diagnostic approach, and management strategies for each type. The diagnostic approach involves taking a thorough history, performing a physical examination, and ordering imaging tests only if indicated. Management involves both acute and preventative treatment depending on the headache type. The document emphasizes the importance of making an accurate diagnosis and reassuring patients that other pathology has been excluded.
Hedache classification migraine management neurologykota
This document discusses the classification and management of migraine headaches. It begins by outlining the International Classification of Headache Disorders criteria for classifying different types of migraines, including migraine without aura, migraine with aura, hemiplegic migraine, and chronic migraine. It then discusses the epidemiology, pathophysiology involving CGRP and other factors, and diagnostic criteria for some of the main migraine subtypes. The remainder of the document focuses on guidelines for managing acute migraines, preventing migraines, and treating refractory or chronic migraines, including in special populations like pregnancy and children. Treatment options discussed include triptans, CGRP antagonists, topiramate, valproate, and neurom
Unusual Headaches
The document discusses different types of headaches including:
1) Trigeminal autonomic cephalalgias which include cluster headache, paroxysmal hemicrania, and SUNCT/SUNA. Cluster headache is characterized by severe unilateral orbital or temporal pain lasting 15-180 minutes with associated autonomic symptoms.
2) Trigeminal neuralgia which causes sharp, stabbing pains in the face triggered by light touch in specific areas innervated by branches of the trigeminal nerve.
3) A case of cluster headache is then presented in more detail to illustrate the distinguishing features between cluster headache and other primary headache disorders.
Movement disorders emergencies
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Pathophysiology of migraine
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Similar to Rajkot press
Drug induced movement disorders
This document discusses drug-induced movement disorders caused by antipsychotic medications. It covers the classification of both acute and chronic movement disorders including dystonia, parkinsonism, akathisia, and tardive dyskinesia. It discusses the pathophysiology, risk factors, signs and symptoms, time of onset, scales used for assessment, management, and prevention of these medication-induced movement disorders. It also lists other medications that can cause movement disorders and the DSM-5 diagnostic categories for medication-induced movement disorders.
Approach to tremors
This document discusses the approach to tremors. It defines tremors and classifies them based on frequency, phenomenology, distribution, and etiology. Tremors can be rest tremors, action tremors such as postural tremors and kinetic tremors. Essential tremor is the most common cause of pathological tremor. Parkinson's disease causes rest tremors. Cerebellar tremors have a low frequency. Evaluation of tremors involves history, examination of affected body parts, tremor characteristics, and investigations like MRI and DAT scan to identify the underlying cause. Treatment depends on the cause but may include medications, botulinum toxin injections, or deep brain stimulation.
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The document discusses Parkinson's disease (PD), a progressive nervous system disorder that causes movement-related issues like tremors and stiffness. It begins by introducing PD and its common symptoms. It then discusses the etiology, pathophysiology, clinical manifestations, complications, diagnosis, treatment options including medications and surgery, nursing management considerations, and potential nursing diagnoses for patients with PD. The main points are that PD is caused by the loss of dopamine-producing neurons in the brain, leading to motor symptoms, and is typically treated through dopamine replacement therapies like levodopa although surgery may be an option in some cases. Nursing care involves monitoring symptoms and functioning, educating on treatments and self-care, and addressing issues like impaired mobility and communication
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Tues 8-00 Parkinson’s Disease- The Basics.pptx
I would do the following:
1. Assess for delirium by checking vital signs, mental status, and reviewing the medication list for any recent changes.
2. Taper and discontinue the ropinirole and alprazolam which can worsen hallucinations.
3. Consider reducing the levodopa dose gradually if hallucinations persist after stopping the other medications.
4. Initiate a trial of quetiapine or clozapine which are less likely to worsen parkinsonism compared to other antipsychotics. Start low and titrate slowly.
5. Reassure the patient and family that the hallucinations are likely due to Parkinson's disease progression and
Parkinsion.
Parkinson's disease is a progressive neurodegenerative disorder that affects movement. It is caused by the loss of dopamine-producing neurons in the brain. The main symptoms are tremors, rigidity, bradykinesia, and impaired balance and coordination. There is no cure for Parkinson's, but treatment aims to manage symptoms through medication and sometimes surgery. Nursing management focuses on maintaining mobility and self-care abilities, addressing complications, ensuring adequate nutrition, and supporting coping.
Parkinsonism
Parkinsonism is an umbrella term that includes Parkinson's disease and other conditions that share certain symptoms but have different causes. These atypical Parkinsonian syndromes include Lewy body dementia, multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration. While symptoms of PD and atypical Parkinsonism overlap, atypical syndromes tend to develop earlier and progress faster, affecting both sides of the body. Diagnosis involves evaluating symptoms, medical history, neurological exams, and brain imaging. Currently there are no cures, but treatment focuses on managing symptoms through medication and physical therapy.
barkinson's disease
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.
pharmacological management of parkinson diesease
Title: Exploring the Pharmacological Management of Parkinson's Disease: A Comprehensive Analysis
Abstract:
Parkinson's Disease (PD) is a complex neurological disorder characterized by progressive motor symptoms such as tremors, rigidity, and bradykinesia. While there is currently no cure for PD, pharmacological interventions play a crucial role in managing its symptoms and improving the quality of life for patients. This presentation provides a comprehensive analysis of the pharmacological management of Parkinson's Disease, covering the mechanisms of action, efficacy, side effects, and challenges associated with various medications used in its treatment. Through an in-depth exploration of the available pharmacotherapies, this presentation aims to equip healthcare professionals with the knowledge necessary to make informed decisions in the management of PD patients.
Introduction:
Parkinson's Disease (PD) is the second most common neurodegenerative disorder, affecting millions of people worldwide. Its hallmark motor symptoms, including bradykinesia, rigidity, and resting tremor, result from the progressive degeneration of dopaminergic neurons in the substantia nigra. While the exact cause of PD remains elusive, its management primarily revolves around symptomatic relief and slowing disease progression. Pharmacological interventions constitute the cornerstone of PD treatment, targeting various aspects of the underlying pathophysiology. This presentation delves into the pharmacological management of PD, elucidating the mechanisms of action, efficacy, and adverse effects of commonly prescribed medications.
Dopaminergic Therapy:
Central to the pharmacological management of PD is the restoration of dopamine levels in the brain. Levodopa, a precursor of dopamine, remains the most effective medication for alleviating motor symptoms. However, its long-term use is often complicated by motor fluctuations and dyskinesias. This presentation explores the pharmacokinetics and pharmacodynamics of levodopa, alongside strategies for optimizing its efficacy while minimizing adverse effects. Additionally, adjunctive therapies such as carbidopa and dopamine agonists are examined for their role in enhancing dopaminergic function and mitigating levodopa-related complications.
Monoamine Oxidase Inhibitors (MAOIs) and Catechol-O-Methyltransferase (COMT) Inhibitors:
Inhibition of enzymes involved in dopamine metabolism represents another pharmacological approach in PD management. Monoamine oxidase inhibitors (MAOIs) and catechol-O-methyltransferase (COMT) inhibitors prolong the half-life of dopamine, thereby enhancing its availability in the synaptic cleft. Selegiline and rasagiline, selective MAO-B inhibitors, are discussed in terms of their neuroprotective effects and symptomatic relief in early-stage PD. Furthermore, the role of COMT inhibitors such as entacapone in prolonging levodopa's duration of action is examined, along with their potential side effects
Presentation on Emergency Medications.
Emergency medications are used to treat life-threatening conditions and save patients' lives. They work by controlling symptoms, normalizing vital functions, and diverting patients from risks. Common categories include anti-cholinergics, inotropic agents, muscle relaxants, diuretics, anti-epileptics, neuroleptics, anti-asthmatics, corticosteroids, local anesthetics, sedatives and induction agents, opioid analgesics, anti-emetics, anti-hypertensives, anti-arrhythmics, intravenous fluids, and tetanus prophylaxis. As an emergency nurse, it is important to be familiar with these medications and their uses, dosages
Parkinson's disease
Parkinson's disease is a neurodegenerative disorder that results from the loss of dopamine-producing neurons in the substantia nigra region of the brain. This leads to decreased dopamine levels in the basal ganglia and symptoms like tremors, rigidity, slowed movement, and impaired balance. The disease was first described in 1817 and is diagnosed based on the presence of two of the four main motor symptoms. Treatment options include dopamine replacement medications, surgery like deep brain stimulation to regulate motor circuits, and experimental therapies involving fetal or stem cell transplants.
Anesthesia for pd
lecture i gave it in 15 of oct 2014 in university hospital ground round about anesthesia for parkinson disease
Parkinsonism
1. Parkinsonism is a progressive neurodegenerative disorder caused by loss of dopamine-producing neurons in the substantia nigra, leading to motor symptoms like bradykinesia, rigidity, resting tremor, and impaired balance.
2. Treatment aims to restore dopamine levels through levodopa or dopamine agonists to improve motor symptoms, and anticholinergics to reduce acetylcholine activity in the striatum.
3. Levodopa is most effective but side effects emerge with long term use, so combinations with carbidopa are used to sustain dopamine levels and minimize side effects.
Parkinson’s Disease
Parkinson's disease is a movement disorder caused by the loss of dopamine-producing neurons in the brain. The main symptoms include tremors, muscle rigidity, slow movement, and impaired balance and coordination. As dopamine levels decrease, motor functions become more difficult to control. There is no known cause but both genetic and environmental factors are thought to play a role. While there is no cure, treatment aims to replace dopamine or mimic its effects through drugs and deep brain stimulation. Diet and exercise are also important to manage symptoms and potential nutrition issues related to the disease.
Antiparkinsonian drugs.pptx
This document discusses antiparkinsonian drugs used to treat Parkinson's disease. It defines Parkinsonism as a motor disorder caused by an imbalance of acetylcholine and dopamine in the basal ganglia. The main types of Parkinson's disease are described as idiopathic, vascular, inherited, and drug-induced. Antiparkinsonian drugs work by increasing dopamine levels through precursor drugs like levodopa, agonists, and inhibitors of enzymes that break down dopamine. Levodopa is discussed in detail, along with its mechanism of increasing dopamine in the brain. Adverse effects and drug interactions of levodopa are also summarized.
PARKINSON DISEASE_032244.pptx
The document discusses Parkinson's disease (PD), a progressive neurodegenerative disorder characterized by movement-related symptoms like bradykinesia, rigidity, tremor, and gait impairment. PD results from the loss of dopamine-producing neurons in the substantia nigra. This leads to reduced striatal dopamine and an imbalance between excitatory acetylcholine and inhibitory dopamine in the basal ganglia. Clinically, PD presents with motor symptoms like resting tremor, cogwheel rigidity, hypokinesia, and postural instability. Treatment involves dopaminergic medications as well as physical and speech therapy to manage symptoms.
Antipsychotics
This document discusses antipsychotic and mood stabilizing drugs. It begins by classifying antipsychotics such as phenothiazines, butyrophenones, and atypical antipsychotics. It then describes the mechanism of action, uses, and adverse effects of typical antipsychotics like chlorpromazine and haloperidol. Atypical antipsychotics like clozapine and risperidone are also discussed. The document also covers mood stabilizers lithium and sodium valproate, focusing on lithium's mechanism and use in treating mania and bipolar disorder. Management of schizophrenia, mania, and bipolar disorder is described.
parkinsonism.pptx
Parkinson's disease is a progressive neurological disorder characterized by bradykinesia and other motor symptoms like rigidity, tremor, and impaired balance. It results from the loss of dopamine-producing neurons in the substantia nigra. The average age of onset is 60, and it is more common in men. While motor symptoms are prominent, non-motor symptoms like cognitive impairment and mood issues become predominant as the disease progresses. Levodopa remains the most effective treatment but can cause side effects, so other drugs and therapies are also used to manage symptoms of Parkinson's disease.
PARKINSON.pptx
Parkinson's disease is a progressive nervous system disorder that affects movement. It occurs when certain nerve cells in the brain don't produce enough of the chemical dopamine. The main symptoms include tremors, stiffness, slow movement, and impaired balance and coordination. It is treated mainly with medications to replace dopamine like levodopa, but physiotherapy can help maintain mobility and flexibility as the disease progresses through its stages.
Pharmacotherapy of parkinsons disease
Parkinson's disease is a neurodegenerative disorder caused by loss of dopamine-producing brain cells. Common symptoms include tremor, stiffness, slowness, and impaired balance. Age is the largest risk factor, and most cases occur in people over 60. Current drug treatments aim to replace dopamine or stimulate dopamine receptors. Levodopa is most effective but long-term use can cause motor complications. Other drugs include dopamine agonists, MAO-B inhibitors, anticholinergics, and COMT inhibitors. Non-motor symptoms like sleep disturbances, mood changes, and gastrointestinal issues also occur and may require additional medication management. New drugs targeting underlying disease mechanisms instead of symptoms are under investigation.
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Rajkot press
- 1. Surgery for Movement and Psychiatric Disorders Dr. Paresh K Doshi In-charge Stereotactic and Functional Neurosurgical Program Jaslok Hospital and Research Centre
- 2. Movement Disorders • Parkinson’s Disease • Tremors • Dystonia
- 3. Parkinson’s Disease • Tremors, slow movements, stiffness, postural instability • 8-20/10,000 • Usually associated with old age- young not uncommon • Levodopa treatment most effective initially
- 4. Medical Management •Levodopa- Dopamine replacement •Other drugs: •Dopamine agonists like ropinarole, pramipexole etc. •Side effects: •NauseaVomiting •Dyskinesias, Hallucinations, Constipation
- 5. Who is the best surgical candidate • Usually >5yrs of disease • on-off fluctuations • Significant dyskinesias • Off phase dystonia and pain • Uncontrolled tremors • Levodopa responsive symptoms
- 7. Surgical strategies for Parkinson’s Disease LesionLesion StimulationStimulation Subthalamic nucleusSubthalamic nucleus
- 8. What is Deep Brain Stimulation IPG LEAD
- 9. What is Deep Brain Stimulation
- 10. STN Lesion
- 11. • Total no. of Movement Disorders Surgeries- 254 • Deep brain stimulation surgeries-182 • DBS for PD-162 Demographics
- 13. Surgery
- 15. Real Estate Consultant Back on his Legs
- 16. Preop 1Y Postop 3Y Postop
- 18. N=30 N=26 59% 54% Doshi et al, Neurology India 2004 Doshi et al, Movement Disorder 2006 Results
- 19. N=30 N=26 36% 38% Doshi et al, Neurology India 2004 Doshi et al, Movement Disorder 2006 Results
- 20. STN Lesioning
- 21. After 5 years
- 22. Thank You
Editor's Notes
- Dbs consists of implantation of the electrode in deeply located cells of the brain. This electrode is only 1 mm in diameter and has four contact points that can be used to deliver current. The electrode is connected to a pacemaker with the help of subcutaneously tunneled wires brought down behind the ear. The pacemaker is implanted below the collar bone under the pad of skin and fat. This whole system is implanted in such a way that it is not visible easily to the onlooker. Current is generated in the pacemaker and is delivered to the brain cells via one of the contact points.
- The advantage of deep brain stimulation is its immense flexibility in delivering current. The whole system can be programmed from outside, giving the physician complete freedom to tailor the treatment to suit each individual patients need, one can even choose different combinations of current parameters for the right and left side of brain. Patients are given a small remote control known as access device. With the help of this the patients can alter current setting to suit their daily requirements. As the limits of this alterations can be set by the physician, there is no fear of harming one self.