Prescribing considerations in the use of oral medication in Parkinson's disease

2021 ◽  
Vol 3 (10) ◽  
pp. 396-403
Author(s):  
Jane Price ◽  
Hannah Martin ◽  
Louise Ebenezer
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Adverse Effects ◽  
Impulse Control ◽  
Symptom Control ◽  
Motor Fluctuations ◽  
Disease Trajectory ◽  
Oral Medications

The aim of this article is to consider and support the rationale for prescribing decisions throughout the Parkinson's disease trajectory. The authors will discuss the challenges of managing both motor and non-motor features of Parkinson's disease mindful of potential complications attributable to both progression and medications used. This will include motor fluctuations and impulse control behaviours, which can adversely affect quality of life. The Parkinson's specialist will need to consider a treatment regimen that optimises symptom control while limiting the potential adverse effects of medications. This article will provide an overview of oral medications used throughout the recognised stages of Parkinson's disease.

Quality of life in Parkinson's disease patients with motor fluctuations and dyskinesias in five European countries

2014 ◽  
Vol 20 (9) ◽  
pp. 969-974 ◽  
Author(s):  
Marlene C. Hechtner ◽  
Thomas Vogt ◽  
York Zöllner ◽  
Sabrina Schröder ◽  
Julia B. Sauer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Fluctuations ◽  
European Countries

Effect of impulse control disorders on disability and quality of life in Parkinson’s disease patients

2014 ◽  
Vol 21 (1) ◽  
pp. 63-66 ◽  
Author(s):  
Amy L. Phu ◽  
Zheyu Xu ◽  
Vlasios Brakoulias ◽  
Neil Mahant ◽  
Victor S.C. Fung ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Impulse Control ◽  
Impulse Control Disorders

scholarly journals Long-term effectiveness of levodopa-carbidopa intestinal gel on motor and non-motor symptoms in advanced Parkinson’s disease: results of the Italian GLORIA patient population

2020 ◽  
Vol 41 (10) ◽  
pp. 2929-2937 ◽  
Author(s):  
Angelo Antonini ◽  
Pietro Marano ◽  
Graziano Gusmaroli ◽  
Nicola Modugno ◽  
Claudio Pacchetti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Motor Fluctuations ◽  
Motor Symptoms ◽  
Italian Population ◽  
Advanced Parkinson’S Disease ◽  
Non Motor Symptoms

Abstract Introduction The GLORIA registry included 375 advanced Parkinson’s disease (PD) patients and evaluated the efficacy and safety of a 24-month levodopa-carbidopa intestinal gel (LCIG) treatment in routine medical care. This analysis focuses on the Italian population, 60 patients treated with LCIG in 7 specialised PD care centres. Methods Hours of “Off” and “On” time were assessed with a modified version of the Unified Parkinson’s Disease Rating Scale (UPDRS) part IV items 39 and 32. Motor fluctuations, dyskinesia, non-motor symptoms, quality of life and safety were evaluated. Results Overall, 42 (70%) out of 60 patients completed the registry. LCIG treatment reduced “Off” time (− 3.3 ± 2.7 h at month 24 (M24), P < 0.0001), increased “On” time with dyskinesia (− 2.6 ± 5.2 h at M12, P = 0.0160), and improved UPDRS II and UPDRS III total scores at M24 (− 4.5 ± 10.6, P = 0.0333 and − 4.9 ± 11.7, P = 0.0229, respectively), Non-Motor Symptom Scale (NMSS) total score (− 21.8 ± 28.5, P < 0.0001) and Parkinson’s Disease Questionnaire-8 item (PDQ-8) total score (− 12.5 ± 23.9, P = 0.0173) versus previous oral therapy. Adverse drug reactions (ADR) possibly or probably related to treatment were reported in 16 (28.6%) patients. Decreased weight (7.1%), polyneuropathy (7.1%) and abdominal pain (5.4%) were the most frequent ADRs while device malfunction (5.4%) and medical device change (5.4%) were the most reported device complaints. Conclusions LCIG improved motor fluctuations, non-motor symptoms and quality of life over 24 months while tolerability was consistent with the established safety profile.

scholarly journals Possible management of non-motor symptoms of Parkinson’s Disease

2018 ◽  
pp. 69-76
Author(s):  
Aslam Pathan ◽  
Abdulrahman Alshahrani
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Adverse Effects ◽  
Neuronal Degeneration ◽  
Signs And Symptoms ◽  
Motor Symptoms ◽  
Neurologic Disorders ◽  
Non Motor Symptoms

Parkinson's disease (PD) is one of the most common neurologic disorders, affecting approximately 1% of individuals older than 60 years and causing progressive disability that can be slowed but not halted, by treatment. The goal of the medical management of Parkinson's disease is to provide control of signs and symptoms for as long as possible while minimizing adverse effects. Parkinson’s disease (PD) is classically considered as a motor disease, with tremor, rigidity, bradykinesia and gait problems as the classic motor features. However, non-motor manifestations (NMM) of PD have become increasingly recognized – they can often be more disabling than the motor symptoms. Non-motor manifestations of PD result from neuronal degeneration in widespread areas of the brainstem. Unfortunately, NMM is often underrecognized, and therefore, undertreated. The goal of this article is to provide a guide to recognizing and managing these NMM so that quality of life of the patient with PD can improve.

Quality of life in early Parkinson's disease: Impact of dyskinesias and motor fluctuations

2003 ◽  
Vol 19 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Connie Marras ◽  
Anthony Lang ◽  
Murray Krahn ◽  
George Tomlinson ◽  
Gary Naglie ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Fluctuations ◽  
Disease Impact ◽  
Early Parkinson’S Disease

87. Impulse control disorders and the quality of life in Parkinson’s disease

2010 ◽  
Vol 17 (12) ◽  
pp. 1635-1636
Author(s):  
Amy Phu ◽  
Zheyu Xu ◽  
Laraine McAnally ◽  
Vladan Starcevic ◽  
Vlasios Brakoulias ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Impulse Control ◽  
Impulse Control Disorders

scholarly journals Impact of Duodopa on Quality of Life in Advanced Parkinson's Disease: A UK Case Series

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
T. Foltynie ◽  
C. Magee ◽  
C. James ◽  
G. J. M. Webster ◽  
A. J. Lees ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Treatment Options ◽  
Symptom Control ◽  
Case Series ◽  
Objective Evaluation ◽  
Recording Time ◽  
Advanced Parkinson’S Disease

Treatment options in advanced Parkinson’s disease (PD) include subcutaneous apomorphine, pallidal or subthalamic nucleus Deep Brain Stimulation (DBS), or levodopa/carbidopa intestinal gel (LCIG/Duodopa). In this study, we describe the outcome of 12 PD patients with PD related complications started on LCIG, with respect to their quality of life measured by a disease specific validated scale—the PDQ39, together with diaries recording time spent “On,” “Off,” “Dyskinetic,” or “Asleep.” At the time of latest follow up, improvements were observed in both the PDQ39 Summary index as well as diary reports of PD symptom control following introduction of LCIG, supporting its use in well selected patients. The use of a trial period of LCIG via naso-jejunal administration allows objective evaluation of improvement in PD symptom control in advance of the placement of the more invasive percutaneous jejunostomy procedure. The decision to embark on LCIG, apomorphine or DBS should be supported by input from centres with experience of all 3 approaches. Since LCIG is an expensive option, development of the most appropriate future commissioning of this therapy in the absence of Class 1 evidence requires careful scrutiny of the outcomes of its use in a broad range of published series.

scholarly journals Quality of life scale in parkinson's disease PDQ-39 - (Brazilian Portuguese version) to assess patients with and without levodopa motor fluctuation

2007 ◽  
Vol 65 (3b) ◽  
pp. 787-791 ◽  
Author(s):  
Renata Guzzo Souza ◽  
Vanderci Borges ◽  
Sonia Maria Cesar de Azevedo Silva ◽  
Henrique Ballalai Ferraz
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Fluctuation ◽  
Brazilian Portuguese ◽  
Motor Fluctuations ◽  
Portuguese Version ◽  
Quality Of Life Scale ◽  
Life Scale

Quality of life (QoL) is an important treatment outcome indicator in Parkinson's disease (PD). The aim of this study is to assess the usefulness of the Parkinson's disease questionnaire - PDQ-39 (Brazilian Portuguese Version) in measuring QoL of PD patients with or without motor fluctuations. Fifty-six PD patients with mean disease duration of 7.4 years were assessed and 41 of them (73.3%) had motor fluctuations. The PDQ-39 has eight dimensions ranging from 0 to 100; being the higher the score, the worse the QoL. Comparing groups with and without motor fluctuations showed that the dimensions mobility, activities of daily living (ADL), communication and bodily discomfort scored higher in the fluctuating group. There was a tendency to see that the higher the Hoehn and Yahr (HY) scale stages, the higher the PDQ-39 scores. Patients suffering from the disease for more than five years had worse PDQ-39 scores only in the items ADL and communication, when compared with those with the disease for < 5 years. The PDQ-39 is an instrument that detects decrease in QoL of PD patients and the presence of motor fluctuations predicts QoL reduction.

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