Abstract Dopamine agonists DA are a class of drugs which is currently developing and expanding. Publication types English Abstract Review. These medications stimulate the parts of the human brain influenced by dopamine. In effect, the brain is tricked into thinking it is receiving the dopamine it needs. Available Doses:. May receive antinausea medication daily for 3 days before starting medication Indications: Adjunct therapy as needed for OFF periods.
It is the only injectable, fast-acting dopaminergic drug, starts working in 10 minutes and lasts for 90 minutes. Available Doses: 10 mg, 15 mg, 20 mg, 25 mg, and 30 mg sublingual film Typical Treatment Regimen: One 10mg film placed under the tongue as needed, up to five doses per day, separated by at least 2 hours.
These films are similar in appearance to breath freshening strips. However, these are placed under the tongue rather than on top. Not all individuals will experience such side effects. For many people who do experience side effects, they can often be effectively limited or eliminated with careful adjustments to dosage or the timing of the individual doses.
Speak to the treating physician immediately if any side effects are experienced. It is recommended that all prescriptions be filled at the same pharmacy to avoid interactions between medications.
Interactions can be dangerous and even life-threatening, so make sure the pharmacist knows of all medications and supplements being taken, including over-the-counter medications and supplements. Caution: PD medications may have interactions with certain foods, other medications, vitamins, herbal supplements, over the counter cold pills and other remedies.
This treatment delivers electrical pulses to brain cells to decrease motor symptoms. This study aimed to identify the best drug therapy for non-motor symptoms, such as apathy and nighttime restlessness, still present after surgery. Forty people enrolled in this study, five of whom later withdrew. Of the remaining 35 people, 16 were assigned to treatment with a dopamine agonist DA and 19 to treatment with levodopa LD.
Although study participants were required to stop using the other medication for the duration of the study, 14 of 35 people failed to satisfy this requirement and received both DA and LD. Compared with the other two groups, people in the DA group scored more favorably on anxiety, activities of daily living and emotional well-being scales and worse on a motor function scale.
In contrast, people in the DA group had greater changes in perception compared with both LD and DA-LD groups, suggesting that delusions and hallucinations are specific side effects of DA. Impulse control disorders -- syndromes of compulsive gambling, hypersexuality and excessive shopping, to name a few -- improved in all study participants. And they tend to have more side effects than levodopa. Because levodopa controls the symptoms of Parkinson's disease so well-and with so few side effects at the beginning-there is some benefit for people who start treatment with levodopa, rather than with a dopamine agonist.
A person with Parkinson's disease who starts treatment with levodopa may have more early years with better control of symptoms and fewer side effects. But it also is well documented that most people who take levodopa develop motor problems motor fluctuations within 5 to 10 years after starting the medicine. These complications-unpredictable swings in motor control between doses and uncontrollable jerking or twitching dyskinesias -can be hard to manage and can become as disabling as some of the problems caused by the disease itself.
But in the longest study done, people who started treatment with a dopamine agonist had just as many problems with motor fluctuations at 14 years as people who started treatment with levodopa. In an effort to delay the development of motor fluctuations, many doctors are now starting people with early Parkinson's disease on a dopamine agonist rather than levodopa. A dopamine agonist may be used until it no longer adequately relieves symptoms, at which point the person starts taking levodopa in addition to the dopamine agonist.
Dopamine agonists can also cause severe sleep problems, hallucinations, and impulse control issues in some people. Having these side effects may be another reason to switch to levodopa. As long as the person's symptoms are adequately controlled and he or she can tolerate the drug, dopamine agonists may be a good choice for treating early Parkinson's disease. This approach is being used particularly in younger people with Parkinson's disease, because it can delay the need for levodopa and thus may postpone the motor fluctuations that occur with long-term levodopa therapy.
0コメント