ANTI PARKINSONIAN

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Antiparkinsonian drugs

Antiparkinsonian drugs, as the name suggests, are employed against Parkinson's disease. This is a progressive central nervous system disorder characterised by tremors, stiffness, gait disturbances and slow movement in the body. With the complexity of treating Parkinson’s disease, due to lack of cause, the treatment is targeted at improving it’s symptoms. There are a range of Oral Antiparkinsonian drugs which act on different levels, such as levodopa, dopamine agonists, MAO B inhibitors, anticholinergics, COMT inhibitors and amantadine.

What is this medication used for?

Oral antiparkinsonian drugs are used in treatment for parkinson’s disease and symptoms that are similar to Parkinsonism. These drugs treat the difficulties as well as mitigate the symptoms of Parkinson's. Levodopa with carbidopa is the most common combination treatment used, followed by dopamine agonists.

How do Antiparkinsonian drugs work?

Parkinson’s disease is a complex degenerative disorder with no clear clinical cause. Therefore the treatment aims to improve the symptoms. For which, the Oral Antiparkinsonian drugs work through by treating the Parkinson's disease symptoms at different levels. As it is a condition of dopamine deficiency, some drugs such as levodopa and dopamine agonists are involved in replenishing the dopamine and its effects. While other agents inhibit the unwanted symptoms such as stiffness and tremors. Here’s the list of different agents and their working:

Levodopa is a precursor and used by nerve cells to make dopamine

Dopamine agonists stimulate and activate the D1 and D2 dopamine receptors

MAO-B inhibitors slow down the enzymes that breaks down dopamine

COMT inhibitors prolong effect of dopamine

Amantadine reduces involuntary movements in the body
Anticholinergic drugs reduce tremors and muscle rigidity symptoms

What are the common side effects of using these drugs?

The side effects of Oral Antiparkinsonian drugs are moderate to severe in nature and cause discomfort. It is advised to keep a record of side effects and follow up with a doctor, if they get severe and cause adverse health effects. The commonly reported side effects are provided below.

Hallucinations
Vomiting
Dyskinesia
Headache
Dizziness
Confusion
Nausea
Trouble sleeping
Appetite loss
Irregular heartbeat


Warning before use:

The following health warnings provide the predisposed ailments likely to result from the use of these drugs. Check with your doctor for any concerns and other liabilities apart from ones provided below.

Hallucinations
With any of the major Antiparkinsonian drugs, hallucinations are very common and are mostly visual. These can be detrimental to the patient and awareness is to be maintained. Proper and consistent care is essential to prevent it from forming into psychosis.

Compulsive Behaviors
Some people taking this medication have problems controlling compulsive or impulsive behaviour. It is common with levodopa and dopamine agonists agents.

Hence, caution is to be exercised for exhibition of such behaviour. Alternative substitutes and dose adjustments could be needed depending on the condition.

Liver impairment
This medicine increases the risk for liver diseases. Especially around the COMT inhibitors used with the treatment. Caution is to be followed for individuals with such predicament. Usage of suitable alternative with low toxicity is suitable under a doctor’s guidance.

Psychotic disorders
The Oral Antiparkinsonian drug adoption for use in patients has shown an increased chance of developing psychotic conditions such as depression, suicidal thoughts, neurosis, psychosis, anxiety among others. With the burdening effects of the agents and subsequent alterations, the medication is to be used selectively while adjusting the treatment to accommodate the loss in well being.

Dyskinesia
The state of dyskinesia (abnormal, uncontrolled movements) is common with the complications of medication and risks the worsening of a patient's condition.. Individuals that are susceptible to such changes should consult with a doctor. Appropriate pharmaceutical therapy is to be administered to fill the gaps caused with the drug use.

Heart diseases
These drugs in particular, the Dopamine agonist agents increase the risk for heart diseases in the elderly. The therapy is to be modified to the clinical condition of a patient. Regular monitoring and checkups are advised under a doctor’s guidance to avoid such risks.

Other side effects
The medication produces other moderate to severe side effects, such as: dry mouth, blurred vision, upset stomach, feeling nervous, overexcited, poor concentration, fast or low blood sugar, sweating, swollen hands and ankles, and skin reactions. Adequate care and caution is to be followed to mitigate the side effects with clinical guidance.

Drug interactions:

Unintended drug interactions with Oral Antiparkinsonian drugs are harmful and hinder the intended medication’s use in the body. Avoid such instances, by checking with your doctor about the use of medication, both prescriptive and otherwise.

Avoid taking alcohol or such beverages with Antiparkinsonian drugs as severe bouts of dizziness, headache and other symptoms may ensue.

The following are some of such drugs which are to be avoided.

Amitriptyline
Propoxyphene
Sodium oxybate
Amoxapine
Carbamazepine
Dextromethorphan
Droxidopa
Quetiapine
Pramipexole
Duloxetine
Propoxyphene
Sodium oxybate
Acetaminophen
Atorvastatin
Alprazolam
Procarbazine
Linezolid


How to use the drugs:

The medication and its respective dosage is strictly unique and dependent on the treatment of an individual under medical supervision. The dosage schedule is to be strictly followed as per the doctor’s instructions.

It’s best to have a caregiver to carefully monitor the treatment with drugs and see to it that the medication is taken by the patient.

If you missed a dose, check with your doctor. Do not resort to using any other advisory.

It is strongly advised not to go off the medication in between as severe health effects may follow with your condition.

If an overdose is suspected, get to an emergency service or doctor immediately. This situation is of high concern.

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