Parkinson's disease: Difference between revisions

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***Impaired ability to turn or change direction while walking
***Impaired ability to turn or change direction while walking


== Treatmenthttp://www.wikem.org/w/index.php?title=Parkinson%27s_Disease&action=edit&section=3 ==
== Treatmenthttp://www.wikem.org/w/index.php?title=Parkinson%27s_Disease&amp;action=edit&amp;section=<br> ==


*Anticholinergics
*Dopamine agonists <br>
**Benztropine
**Levodopa&nbsp; +Carbidopa (peripheral decarboxylase inhibitor) = gold standard<br>
*Dopamine agonists  
**pramipexole (Mirapex)<br>ropinirole (Requip)<br>
**Levodopa/ Carbidopa<br>
*Anticholenergics<br>
**pramipexole (Mirapex) <br>ropinirole (Requip)<br>  
**Benztropine<br>
*Monoamine oxidase inhibitor - blocks DA reuptake<br>
*Monoamine oxidase inhibitor - blocks DA reuptake<br>  
**selegiline (Eldepryl)<br>
**selegiline (Eldepryl)<br>  
**rasagiline (Azilect)<br>
**rasagiline (Azilect)<br>
**Bromocriptine
 
<br>


==Source==
==Source==

Revision as of 19:58, 5 November 2012

Background

  • Extrapyramidal movement disorder a/w reduced dopaminergic receptors in substantia nigra

Clinical Features

  • TRAP mnemonic:
    • Tremor (resting)
      • Initially is unilateral tremor of upper extremity, esp finger and thumb ("pill rolling")
      • Dissipates when intentional movement is performed
    • Rigidity (cogwheel)
      • Elicited by causing passive movement of limb through full range of motion
    • Akinesia
      • Slowness of voluntary movement
    • Posture/equilibrium impairment
      • Impaired ability to turn or change direction while walking

Treatmenthttp://www.wikem.org/w/index.php?title=Parkinson%27s_Disease&action=edit&section=

  • Dopamine agonists
    • Levodopa  +Carbidopa (peripheral decarboxylase inhibitor) = gold standard
    • pramipexole (Mirapex)
      ropinirole (Requip)
  • Anticholenergics
    • Benztropine
  • Monoamine oxidase inhibitor - blocks DA reuptake
    • selegiline (Eldepryl)
    • rasagiline (Azilect)


Source

Tintinalli

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