Drugs And Medication Used To Treat Parkinsons Disease
A number of different drugs can be used to treat Parkinsons.
Levodopa
Levodopa is the most common treatment for Parkinsons. It helps to replenish dopamine.
About 75 percent of cases respond to levodopa, but not all symptoms are improved. Levodopa is generally given with carbidopa.
Carbidopa delays the breakdown of levodopa which in turn increases the availability of levodopa at the blood-brain barrier.
Dopamine agonists
Dopamine agonists can imitate the action of dopamine in the brain. Theyre less effective than levodopa, but they can be useful as bridge medications when levodopa is less effective.
Drugs in this class include bromocriptine, pramipexole, and ropinirole.
Anticholinergics
Anticholinergics are used to block the parasympathetic nervous system. They can help with rigidity.
Benztropine and trihexyphenidyl are anticholinergics used to treat Parkinsons.
Amantadine
Amantadine can be used along with carbidopa-levodopa. Its a glutamate-blocking drug . It offers short-term relief for the involuntary movements that can be a side effect of levodopa.
COMT inhibitors
Catechol O-methyltransferase inhibitors prolong the effect of levodopa. Entacapone and tolcapone are examples of COMT inhibitors.
Tolcapone can cause liver damage. Its usually saved for people who do not respond to other therapies.
Ectacapone does not cause liver damage.
Stalevo is a drug that combines ectacapone and carbidopa-levodopa in one pill.
MAO-B inhibitors
Recurrent Falls In Parkinsons Disease: A Systematic Review
Natalie E. Allen
1Clinical and Rehabilitation Sciences Research Group, Faculty of Health Sciences, The University of Sydney, P.O. Box 170, Lidcombe, NSW 1825, Australia
Abstract
Most people with Parkinsons disease fall and many experience recurrent falls. The aim of this review was to examine the scope of recurrent falls and to identify factors associated with recurrent fallers. A database search for journal articles which reported prospectively collected information concerning recurrent falls in people with PD identified 22 studies. In these studies, 60.5% of participants reported at least one fall, with 39% reporting recurrent falls. Recurrent fallers reported an average of 4.7 to 67.6 falls per person per year . Factors associated with recurrent falls include: a positive fall history, increased disease severity and duration, increased motor impairment, treatment with dopamine agonists, increased levodopa dosage, cognitive impairment, fear of falling, freezing of gait, impaired mobility and reduced physical activity. The wide range in the frequency of recurrent falls experienced by people with PD suggests that it would be beneficial to classify recurrent fallers into sub-groups based on fall frequency. Given that there are several factors particularly associated with recurrent falls, fall management and prevention strategies specifically targeting recurrent fallers require urgent evaluation in order to inform clinical practice.
1. Introduction
2. Method
3. Results
Get Daily Living Aids That Can Help You Stay Independent And Safe
Among the tools that an occupational therapist might recommend are railings around your toilet and bathtub, a seat to use in the tub or shower, a pump soap dispenser instead of bar soap, an electric toothbrush and razor, a cordless phone that you can carry around with you, nonskid socks and Velcro-closure shoes, and an appropriate cane, walker, rollator or wheelchair to help you move around effectively.
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How Is Parkinsons Disease Diagnosed
A person doesnt need to have all the signs and symptoms of Parkinsons disease to be diagnosed with it.
In general, people have a combination of the motor symptoms and the non-motor symptoms, says Dr. Nwabuobi. Some people have more non-motor symptoms than motor and vice versa, but in order to have a diagnosis of Parkinsons, you definitely need the motor symptoms. Were looking for specific things , including a rest tremor, bradykinesia, rigidity, and poor balance.
According to the Parkinsons Foundation, a person needs to have two of the four main motor symptoms of Parkinsons over a period of time to be diagnosed with the disease.
Problems With Blood Pressure
Problems with blood pressure can affect people generally as they get older, but some Parkinsons medication can cause side effects, including problems with blood pressure. This can lead to dizziness and falls. If youve felt dizzy, or fallen because of dizziness, ask your GP or practice nurse to check your blood pressure both when youre sitting and standing, to see if its too low.
Drugs used to treat other medical conditions, such as high blood pressure, can potentially make dizziness worse, especially if you are losing weight or not eating and drinking as well as you used to.
Postural hypotension is a sudden drop in blood pressure when changing position, for example getting up out of a chair. It can make you feel very light-headed, which will affect your balance. You may experience postural hypotension as a symptom of Parkinsons. But it can also be caused by the drugs used to treat Parkinsons.
You can avoid some dizzy spells by taking your time. For example, before you get out of bed, sit with your feet touching the floor for a few minutes to get your blood flowing. Then stand up slowly, but try not to walk away immediately stand for a while until you feel steady.
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Have You Ever Thought How Challenging Drinking A Glass Of Water Can Be For Someone Suffering From Parkinsons Disease
On World Health Day, youll likely read about how healthy habits like exercising or drinking more water, can improve your health. While these are helpful tips and important topics to cover, we decided to take things a step further. What if you couldnt drink that glass of water by yourself? It can be daunting to consider, but this scenario can become all-too-real for a person suffering from Parkinsons disease. There are 10 million people in the world suffering from this disorder which is why, today, we decided to share with you how Parkinsons Disease can affect mobility and balance, and what can be done when the disorder is detected in its early stages. That is why raising awareness for this degenerative disease is important, and, while there is still much research to be done, we have high hopes that researchers will find a way to reduce the symptoms of Parkinsons disease, and eventually find a cure. This is becoming more and more urgent, given the fact that life expectancy is rising and the number of individuals with Parkinsons disease will only increase in the future. But is there another solution in sight?
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Physical Therapy And Exercise Therapy
Studies of motor learning indicate that repeated and continued physical training may be the best method to counteract the degradation in motor behavior seen in PD. Physical and exercise therapy have long been noted to be beneficial for patients with PD, improving cardinal symptoms activities of daily living and increasing subjective quality of life . Recently, technological advancements in therapy delivery and ability to calculate objective outcome measures has led to an increasing interest in the effects of such therapies on PIGD features of PD. Many studies have noted improvements in gait and balance following these therapies . Studies have focused on determining the best types, intensity, and duration of therapy, the effects of the incorporation of technology , and the duration of sustained effect or need for repeated doses of therapy.
Table 1. Comparison of study design from studies regarding the effect of therapy and training on quantitative measures of gait and balance.
Table 2. Quantitative gait and balance outcomes from training studies.
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Treatment Of Vascular Parkinsonism
The most commonly used medications for vascular Parkinsonism are L-dopa and amantadine. However, some people with Parkinsonism do not experience significant improvement with medication. Some stroke survivors who have vascular Parkinsonism can experience better muscle control with physical therapy. Often, safety measures need to be taken to avoid falls.
If you have already had recurrent strokes resulting in vascular Parkinsonism, you may be at risk of experiencing more strokes over the coming years if no action is taken to reduce your risk. Therefore, if you have been diagnosed with vascular Parkinsonism, it is particularly important to follow up with your healthcare provider in order to prevent additional strokes. You should expect to have testing for stroke risk factors and medical treatment to reduce your risk of stroke.
There are also a number of lifestyle factors that can help reduce stroke risk, such as getting regular moderate exercise and quitting smoking if you smoke. Eating a healthy diet is also important.
What Causes Parkinson Disease
Parkinson disease arises from decreased dopamine production in the brain. The absence of dopamine makes it hard for the brain to coordinate muscle movements. Low dopamine also contributes to mood and cognitive problems later in the course of the disease. Experts don’t know what triggers the development of Parkinson disease most of the time. Early onset Parkinson disease is often inherited and is the result of certain gene defects.
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Can Head Injury Cause Parkinsons Disease Understanding The Link
Kayla Covert, PT, DPT Flint Rehab
Can head injury cause Parkinsons Disease? And does a traumatic brain injury increase a persons chances of developing Parkinsons?
Although it is rare for a head injury to cause Parkinsons, it is a possible secondary effect you should be aware of. Head injuries can also trigger certain movement disorders that look similar to Parkinsons Disease but are in fact different.
Today you will learn more about the link between brain injury and Parkinsons Disease. Then, at the end, well show you how to treat Parkinsons and other motor problems after head injury.
Motor Circuit In Parkinson Disease
The basal ganglia motor circuit modulates the cortical output necessary for normal movement .
Signals from the cerebral cortex are processed through the basal ganglia-thalamocortical motor circuit and return to the same area via a feedback pathway. Output from the motor circuit is directed through the internal segment of the globus pallidus and the substantia nigra pars reticulata . This inhibitory output is directed to the thalamocortical pathway and suppresses movement.
Two pathways exist within the basal ganglia circuit, the direct and indirect pathways, as follows:
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In the direct pathway, outflow from the striatum directly inhibits the GPi and SNr striatal neurons containing D1 receptors constitute the direct pathway and project to the GPi/SNr
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The indirect pathway contains inhibitory connections between the striatum and the external segment of the globus pallidus and between the GPe and the subthalamic nucleus striatal neurons with D2 receptors are part of the indirect pathway and project to the GPe
The STN exerts an excitatory influence on the GPi and SNr. The GPi/SNr sends inhibitory output to the ventral lateral nucleus of the thalamus. Dopamine is released from nigrostriatal neurons to activate the direct pathway and inhibit the indirect pathway. In Parkinson disease, decreased striatal dopamine causes increased inhibitory output from the GPi/SNr via both the direct and indirect pathways .
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How Environmental Factors Could Cause Parkinsons Disease
Scientists differ about the extent that brain cells are impacted by environmental factors. However, the statistics associated with the disease show that the environment can play a very large role in whether parkinsons disease develops.
Most often, it is exposure to toxic chemicals that could play a role in the development of Parkinsons disease. Usually, these combine with genetic factors to produce the conditions that cause Parkinsons.
Increasing scientific evidence suggests that Parkinsons may be caused by environmental factors such as exposure to herbicides such as Paraquat.
What Are The Causes And Symptoms Of Parkinsons Disease
As a neurodegenerative disorder, Parkinsons Disease leads to the progressive deterioration of motor function due to loss of dopamine-producing brain cells. While the cause of Parkinsons Disease is unknown, researchers speculate that both genetic and environmental factors are involved. Studies also show that men are 50% more likely to develop the disorder than women.
Primary symptoms of Parkinsons Disease:
- tremor
- dementia
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How Is Parkinson’s Disease Diagnosed
Someone with the symptoms of Parkinson’s disease may be sent to see a neurologist, a doctor who specializes in the brain, nerves, and muscles. The neurologist may do some tests, including a brain scan and blood tests. These tests will not make the diagnosis of Parkinson’s disease, but the doctor will want to make sure that there is no other problem causing the symptoms. To diagnose Parkinson’s disease, the doctor relies on a person’s medical history, symptoms, and a physical exam.
Symptoms Of Parkinsons Disease
If you have slowness on one side of your body, you should see your doctor. This isnt just a symptom of normal aging. However, symptoms of Parkinson’s disease worsen as you age. These symptoms include tremors, stiffness, slow movement, impaired balance, and a shuffling gait. Some patients may feel more stiffness than others. For some, the tremors are more predominant. You may also have a hard time forming facial expressions.
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Have An Educated Helper
Most people with Parkinsons disease need the help of one or more caregivers to get through the day. If you are a caregiver, one of the most important things you can do is read up on Parkinsons disease, so that you can understand what your loved one is going through. Also, be involved by attending doctors appointments and therapy sessions. Often, these professional healthcare providers will have tips and advice for the caregiver as well as the person living with the disease.
Causes
In Parkinsons disease, certain nerve cells in the brain gradually break down or die. Many of the symptoms are due to a loss of neurons that produce a chemical messenger in your brain called dopamine. When dopamine levels decrease, it causes abnormal brain activity, leading to signs of Parkinsons disease.
The cause of Parkinsons disease is unknown, but several factors appear to play a role, including:
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Your genes. Researchers have identified specific genetic mutations that can cause Parkinsons disease, but these are uncommon except in rare cases with many family members affected by Parkinsons disease.
However, certain gene variations appear to increase the risk of Parkinsons disease but with a relatively small risk of Parkinsons disease for each of these genetic markers.
- Environmental triggers. Exposure to certain toxins or environmental factors may increase the risk of later Parkinsons disease, but the risk is relatively small.
What Is Parkinson Disease
Parkinson disease is a movement disorder. It can cause the muscles to tighten and become rigid This makes it hard to walk and do other daily activities. People with Parkinsons disease also have tremors and may develop cognitive problems, including memory loss and dementia.
Parkinson disease is most common in people who are older than 50. The average age at which it occurs is 60. But some younger people may also get Parkinson disease. When it affects someone younger than age 50, it’s called early-onset Parkinson disease. You may be more likely to get early-onset Parkinson disease if someone in your family has it. The older you are, the greater your risk of developing Parkinson disease. It’s also much more common in men than in women.
Parkinson disease is a chronic and progressive disease. It doesn’t go away and continues to get worse over time.
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Parkinsons Disease And Sleep
Parkinsons disease is a progressive neurodegenerative disorder characterized by the loss of dopamine-producing nerve cells in the brain. Dopamine is a cell-signaling molecule that relays information between nerve cells and between the brain and the muscles. The loss of dopamine leads to symptoms of the motor system such as tremor, bradykinesia , impaired balance, and rigidity. It can also cause non-motor symptoms, including speech, cognitive, mood, and sleep problems.
Most sleep problems in Parkinsons patients can be broken down into one of three categories: trouble falling asleep, trouble staying asleep or getting restful sleep, or falling asleep at the wrong times.
Advancing Age And Parkinsons Disease
Age is perhaps the biggest risk factor for the onset of Parkinsons disease. The average age at which people will develop this movement disorder is 60. This is not usually something that affects younger people. The brain ages as people get older.
Even without external factors, cells in the substantia nigra can die on their own as an individual ages, causing symptoms to develop as the person gets older.
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Falls And Common Household Hazards
If you or a loved one has Parkinson’s disease, here are tips for preventing falls around the home:
- Floors. Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its accustomed place.
- Bathroom. Install grab bars and nonskid tape in the tub or shower. Use nonskid bath mats on the floor or install wall-to-wall carpeting.
- Lighting. Make sure halls, stairways, and entrances are well lit. Install a night light in your bathroom or hallway. Make sure there is a light switch at the top and bottom of the staircase. Turn lights on if you get up in the middle of the night. Make sure lamps or light switches are within reach of the bed if you have to get up during the night.
- Kitchen. Install nonskid rubber mats near the sink and stove. Clean up spills immediately.
- Stairs. Make sure treads, rails, and rugs are secure. Install a rail on both sides of the stairs. If stairs are a threat, it may be helpful to arrange most of your activities on the lower level to reduce the number of times stairs must be climbed.
- Entrances and doorways. Install metal handles on the walls adjacent to doorknobs of all doors to make it more secure as you travel through the doorway.
What Lifestyle Changes Can I Make To Ease Parkinsons Symptoms
Exercise: Exercise helps improve muscle strength, balance, coordination, flexibility, and tremor. It is also strongly believed to improve memory, thinking and reduce the risk of falls and decrease anxiety and depression. One study in persons with Parkinsons disease showed that 2.5 hours of exercise per week resulted in improved ability to move and a slower decline in quality of life compared to those who didnt exercise or didnt start until later in the course of their disease. Some exercises to consider include strengthening or resistance training, stretching exercises or aerobics . All types of exercise are helpful.
Eat a healthy, balanced diet: This is not only good for your general health but can ease some of the non-movement related symptoms of Parkinsons, such as constipation. Eating foods high in fiber in particular can relieve constipation. The Mediterranean diet is one example of a healthy diet.
Preventing falls and maintaining balance: Falls are a frequent complication of Parkinson’s. While you can do many things to reduce your risk of falling, the two most important are: 1) to work with your doctor to ensure that your treatments whether medicines or deep brain stimulation are optimal and 2) to consult with a physical therapist who can assess your walking and balance. The physical therapist is the expert when it comes to recommending assistive devices or exercise to improve safety and preventing falls.
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