Review of medicine utilization for Parkinson’s disease management: the Bulgarian perspective

Background: Parkinson’s disease (PD), which occurs in 1% of the population, is the second most common neurodegenerative disorder. Despite the broad spectrum of PD manifestations and high disease prevalence, there are insufficient data on medicine utilization and prescription strategies. The purpose of the current study was to analyze published data concerning treatment approaches and to compare them with Bulgarian therapeutic practice.Design and methods: We conducted a systematic review of the PubMed and Google Scholar databases, and we calculated medicine utilization in Bulgaria during 2018 and 2019 using the WHO methodology.Results: The literature search identified a total of 311 publications, but only 12 met the inclusion criteria. Eleven studies pointed out that levodopa-containing medicine are the most frequently used, followed by dopamine agonists. The highest rate was found for levodopa-containing products and decarboxylase inhibitor (1.06 and 1.33 DDD/1000 inh/day), followed by anticholinergic Biperiden (0.494 and 0.455 DDD/1000 inh/day) during 2018 and 2019 in Bulgaria.Conclusion: Overall, the treatment approaches used in the last decade comply with guideline recommendations, despite variations in levodopa and dopamine agonist utilization. Even though new medicines have been approved for PD management, levodopa-containing products are still most often prescribed and used worldwide.

Reaction of Carbidopa with cis-[Cr(C2O4)2(H2O)2]− in Aqueous Medium: A Kinetic, Mechanistic and Antiparkinsonian Study of the Product Complex

For the treatment of Parkinson′s disease, the second most common neurodegenerative disorder, requires a combination of levodopa with a peripheral decarboxylase inhibitor, such as carbidopa which provides a symptomatic relief to patients. Reaction of carbidopa with cis-[Cr(C2O4)2(H2O)2]– has been carried out in aqueous medium over the range 35 ≤ t ≤ 50 ºC, 4.0 ≤ pH ≤ 6.0 , 3.75 × 10-3 mol dm-3 ≤ [carbidopa] ≤ 9.38 × 10-3 mol dm-3, I (KNO3) = 0.1 mol dm-3. There is outersphere association between cis-[Cr(C2O4)2(H2O)2]– and conjugate base of carbidopa followed by first chelation. The characterization of the product was performed by using NMR and infrared spectroscopies. The product showed better antiparkinsonian activity than the combination of levodopa and carbidopa

Corilagin attenuates the Parkinsonismin Japanese encephalitis virus induced Parkinsonism

This study evaluates the protective effect of corilagin against Parkinsonismin Japanese encephalitis virus (JEV) induced Parkinson’s disease. The JaGAr-01 strain of virus was used to induce JE. The virus was injected into the rats (13 days age) at the midpoint between the two ears. Adult rats, 12 week after the inoculation of virus, were used for the further study. Corilagin (20 mg/kg) and levodopa with dopa decarboxylase inhibitor (LEV, 10 mg/kg) were administered intraperitoneally for the duration of one week. Bradykinesia and the levels of dopamine in the brain were estimated at the end of protocol. There was a significant decrease inthe motor function in the corilagin, LEV and LEV + corilagin treated groupscompared to the negative control group. However treatment with corilagin, LEV and LEV + corilagin significantly increases the level of dopamine in the brain compared to the negative control group. This study concludes that corilagin ameliorates the Parkinsonismin JEV induced Parkinsonism. Moreover it shows a synergistic effect when treated with LEV. Data presented in the investigation supports that corilagin can be used clinically.