On demand therapy for Parkinson’s disease patients: Opportunities and choices
نویسندگان
چکیده
Levodopa is the most effective symptomatic treatment for Parkinson’s disease (PD), but a major challenge that over time, many patients experience periods of return PD symptoms intermittently through day, known as OFF periods. typically manifest motor can also involve non-motor and these disrupt good control despite optimization oral levodopa regimen. emerge in large measure due to shortening duration clinical benefit from levodopa, thought be related progressive loss dopamine neurons their ability store release levodopa-derived hours. The problem further compounded by impaired absorption gastroparesis other factors limiting its uptake small intestine, including competition meals protein content. On-demand therapies are now available episodes administered intermittently, on an as-needed basis, top patient’s maintenance medication To useful, on-demand should take effect more rapidly reliably than levodopa. Options therapy have recently increased with approval inhalation powder sublingual apomorphine alternatives older option subcutaneous injection, each which avoids gastrointestinal tract potential delay. experiencing episodic or intermittent need rapid reliable onset benefit. may provide alternative invasive such infusion levodopa/carbidopa intestinal gel whose not controlled deep brain stimulation.
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ژورنال
عنوان ژورنال: Postgraduate Medicine
سال: 2021
ISSN: ['1941-9260', '0032-5481']
DOI: https://doi.org/10.1080/00325481.2021.1936087