Levodopa On Parkinson's disease
Levodopa has been the most widely used treatment for over 30 years.
L-DOPA is converted into dopamine in the dopaminergic neurons by dopa
decarboxylase. Since motor symptoms are produced by a lack of dopamine
in the substantia nigra, the administration of L-DOPA temporarily
diminishes the motor symptoms.
Only 5–10% of L-DOPA
crosses the blood–brain barrier. The remainder is often metabolized to
dopamine elsewhere, causing a variety of side effects including nausea,
dyskinesias and joint stiffness. Carbidopa and benserazide are
peripheral dopa decarboxylase inhibitors, which help to prevent the
metabolism of L-DOPA before it reaches the dopaminergic neurons,
therefore reducing side effects and increasing bioavailability. They are
generally given as combination preparations with levodopa. Existing
preparations are carbidopa/levodopa (co-careldopa) and
benserazide/levodopa (co-beneldopa). Levodopa has been related to
dopamine dysregulation syndrome, which is a compulsive overuse of the
medication, and punding. There are controlled release versions of
levodopa in the form intravenous and intestinal infusions that spread
out the effect of the medication. These slow-release levodopa
preparations have not shown an increased control of motor symptoms or
motor complications when compared to immediate release preparations.
Tolcapone inhibits the COMT enzyme, which degrades dopamine, thereby
prolonging the effects of levodopa. It has been used to complement
levodopa; however, its usefulness is limited by possible side effects
such as liver damage. A similarly effective drug, entacapone, has not
been shown to cause significant alterations of liver function. Licensed
preparations of entacapone contain entacapone alone or in combination
with carbidopa and levodopa.
Levodopa
preparations lead in the long term to the development of motor
complications characterized by involuntary movements called dyskinesias
and fluctuations in the response to medication. When this occurs a
person with PD can change from phases with good response to medication
and few symptoms ("on" state), to phases with no response to medication
and significant motor symptoms ("off" state). For this reason, levodopa
doses are kept as low as possible while maintaining functionality.
Delaying the initiation of therapy with levodopa by using alternatives
(dopamine agonists and MAO-B inhibitors) is common practice. A former
strategy to reduce motor complications was to withdraw L-DOPA medication
for some time. This is discouraged now, since it can bring dangerous
side effects such as neuroleptic malignant syndrome. Most people with PD
will eventually need levodopa and later develop motor side effects.
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ReplyDeleteI am a 51 year old female that just found out I have Parkinson's about a year and half, but I have been having signs of it for years, tremors, depression, body weakness. ECT. I honestly don't think my doctor was reading the signs because of my gender and age. A few years ago I had my shoulder lock up on me and I was sent to a P.T since x-rays didn't show any physical damage. My shaking was getting worse and I began falling. Only when my speech became so bad that it brought concern to my dentist was Parkinson's even considered. He phoned my doctor with his concerns about my shaking and balance problems. By this time I was forgoing shots in the back of my neck for back and neck pain to which once again I was sent to a P.T (although x-rays showed no damage) I was told I had a few spurs which were most likely causing the pain. Here I was feeling like my whole body was falling apart and doctor could not find anything wrong, maybe in was all in my head? My doctor even seemed annoyed with me and things just kept progressing and I just kept it to myself, why bother going through testing and them finding nothing? Well, it was after my second P.T called my doctor about the weakness in my legs and arms, by this time I have developed a gait in my walk and I fell more frequently. Only then did my doctor send me to a specialist and it was found that I had Parkinson's, and that I have had it for awhile. I think because I was a woman that my signs and symptoms weren't taken seriously and therefor left untreated for so long,I was taking pramipexole dihydrochloride three times daily, I Was on carbidopa levodopa but only lasted 90 minutes then wore off.I found that none of the current medications worked effective for me.I got tired of using those medication so I decided to apply natural herbs formula that was prescribed to me by my second P.T, i purchase the herbal formula from totalcureherbsfoundation. com, There has been huge progression ever since I start the treatment plan which will last for 15 weeks usage.all the symptoms and sign has begin to disappear .
ReplyDeleteMy husband was diagnosed with early onset Parkinson's disease at 68. His symptoms were shuffling of feet, slurred speech, low volume speech, degradation of hand writing, horrible driving skills, right arm held at 45 degree angle. Things were tough for me, I too was diagnosed of COPD but now we both finally free from these diseases with the help of total cure herbal foundation, He now walks properly and all symptoms has reversed. He had trouble with balance especially at night, getting into the shower and exiting it is difficult. Getting into bed is also another thing he finds impossible. We had to find a better solution for his condition which has really helped him a lot,The biggest helped we had was totalcureherbsfoundation com They walked us through the proper steps, im highly recommending this herbal formula to anyone who needs help.
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ReplyDeleteMy symptoms started at the age of 47. My fingers on my left hand were stiff and were difficult to move. People noticed that my walk was not normal. I was often asked did I hurt.I noticed nothing different about my walk. It was difficult getting up from a chair and getting out of a car. I was diagnosed a year later, it was the onset of tremors starting in my right hand that caused my other symptoms to be recognized as Parkinson's.I am now 59. With the new herbal medicine i purchase from totalcureherbalfoundation.blogspot.com was my only way to get fast relief from this PD,their herbal supplement effectively reverse my Parkinson's disease condition and alleviate all my symptoms.
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