Trends in Parkinson's Rx and levodopa complication risk factors.
Journal name: World Journal of Pharmaceutical Research
Original article title: Prescribing trends in parkinson’s disease and risk factors involved with levodopa induced motor complication in a teritiary care hospital
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Prof. Dr. Mathew George, Prof. Dr. Lincy Joseph, Mincy Mathew, Jiya Ann Mathew and Teena Thomas
World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: Prescribing trends in parkinson’s disease and risk factors involved with levodopa induced motor complication in a teritiary care hospital
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Doi: 10.20959/wjpr201816-13115
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Summary of article contents:
Introduction
Parkinson's disease is the second most prevalent neurodegenerative disorder, primarily affecting dopaminergic neurons in the substantia nigra of the brain. It impacts roughly 1.5 to 2% of individuals over the age of 60, leading to progressive motor impairments such as tremors, rigidity, bradykinesia, and postural instability. The progression of the disease varies widely among patients, necessitating tailored pharmacological management. This study aimed to evaluate the prescribing trends of anti-Parkinson drugs and investigate the risk factors associated with motor complications linked to levodopa therapy.
Levodopa and Motor Complications
One significant finding from the study was the prominent role of levodopa, particularly in combination with carbidopa, as the most frequently prescribed anti-Parkinson medication. Long-term use of levodopa is known to be associated with the development of motor complications, particularly dyskinesias, which are involuntary movements commonly occurring due to fluctuations in drug effectiveness. The study indicated that a considerable proportion of patients experienced dyskinesia, with 31.7% reporting these involuntary movements and 65% noting "OFF" periods when the medication was not effective.
Factors Influencing Dyskinesia
The research highlighted the significant factors contributing to dyskinesia in patients using levodopa. Key variables such as total levodopa dose, levodopa equivalent daily dose (LEDD), disease duration, and treatment duration were shown to have a significant correlation with dyskinetic episodes. Particularly, a total levodopa dose greater than 500mg, a disease duration exceeding 10 years, and prolonged treatment with levodopa were all associated with an increased risk of dyskinesia. This reinforces the necessity for clinicians to consider dose adjustments and monitor patients closely over time.
Prescribing Patterns and Concurrent Medications
In the cohort of 60 patients studied, various anti-Parkinson drugs were also prescribed as adjunct therapies, including trihexyphenidyl, amantadine, pramipexole, rasagiline, and ropinirole. Additionally, concurrent medications addressing other health concerns were commonly noted, such as antihypertensives, antiplatelet drugs, antidepressants, and diabetes medications. The overall prescribing pattern suggests that treatment for Parkinson's disease is often complicated by the management of comorbid conditions, which may further influence therapeutic outcomes.
Conclusion
The findings from this study provide essential insights into the prescribing patterns for Parkinson's disease and the prevalent risk factors associated with levodopa-induced motor complications. It was evident that dyskinesia and motor fluctuations are significant challenges in managing patients with Parkinson's disease, primarily influenced by treatment duration and levodopa dosage. Clinicians must approach Parkinson's disease management with careful consideration of these factors to optimize therapeutic benefits and mitigate adverse effects.
FAQ section (important questions/answers):
What was the main aim of the study on Parkinson's disease?
The study aimed to ascertain the prescribing pattern of anti-Parkinson drugs and investigate the risk factors associated with motor complications due to levodopa usage in patients with idiopathic Parkinson's disease.
What are the most commonly prescribed anti-Parkinson drugs?
The most commonly prescribed medication was the levodopa/carbidopa combination. Other frequently prescribed drugs included anti-cholinergics and dopamine agonists, alongside concurrent medications for various cardiac and neurological disorders.
What is the significance of the study's findings on dyskinesia?
The study found that 31.7% of patients experienced dyskinesia and that several factors, including total dose of levodopa and treatment duration, had significant association with these motor complications.
How does disease duration affect the prescribing pattern of anti-Parkinson drugs?
The study indicated that the number of prescribed anti-Parkinson drugs increased with both disease duration and severity, with most patients taking levodopa for 5 to 10 years.
What were the demographics of patients included in the study?
The study comprised 60 patients, with 56.7% males and 43.3% females, diagnosed with idiopathic Parkinson's disease, representing the typical demographic of the disorder.
What conclusion can be drawn from the study regarding levodopa?
The study concludes that total levodopa dose, levodopa equivalent daily dose, and treatment duration significantly influence the occurrence of dyskinesia in patients with Parkinson's disease.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Trends in Parkinson's Rx and levodopa complication risk factors.”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Disease:
Disease refers to Parkinson's disease in this context, which is a common neurodegenerative disorder affecting movement. It is characterized by the deterioration of dopaminergic neurons, leading to symptoms like tremor, rigidity, and bradykinesia. Understanding this disease is crucial for developing effective treatment strategies and assessing motor complications related to it.
2) Drug:
Drug pertains to the anti-Parkinson medications utilized in managing symptoms of Parkinson's disease. Levodopa, often combined with carbidopa, is the first-line treatment for alleviating motor symptoms. The study examined prescribing patterns of these drugs and their associated risks, particularly motor complications stemming from long-term usage.
3) Study (Studying):
Study denotes the research conducted to observe prescribing trends in Parkinson's treatment and analyze the risk factors contributing to levodopa-induced complications. This hospital-based observational study involved 60 patients and aimed to gather insights into patient demographics, drug efficacy, and the prevalence of dyskinesia and motor fluctuations.
4) Pushpagiri (Pushpa-giri, Puspagiri):
Pushpagiri refers to Pushpagiri College of Pharmacy, where the researchers and healthcare practitioners collaborated to conduct the study. The institution provided the clinical setting for data collection, contributing to understand how prescribing patterns affect patients with Parkinson's disease within a tertiary care environment.
5) Male:
Male indicates that within the study population, there was a notable predominance of male patients with Parkinson's disease. Understanding the gender distribution in Parkinson's cases is essential for tailoring treatment approaches and recognizing any potential biological or social factors influencing disease progression and management.
6) Pharmacology:
Pharmacology is the study of drug actions and interactions in the body. In this research, it plays a pivotal role as the researchers analyze the effects of anti-Parkinson drugs, particularly levodopa, on motor symptoms and complications. Knowledge in pharmacology helps inform safe and effective prescribing practices.
7) Knowledge:
Knowledge refers to the understanding gained through the study regarding the prescribing patterns and risk factors associated with Parkinson’s treatment. This includes insights into effective drug combinations and their potential side effects, particularly motor complications, facilitating improved patient management and care techniques.
8) Discussion:
Discussion involves analyzing the results of the study and comparing them with existing literature on Parkinson's disease and its treatments. It allows researchers to interpret findings, highlight significant associations, and present recommendations for clinicians regarding best practices in prescribing anti-Parkinson medications.
9) Medicine:
Medicine encompasses the field that involves diagnosing, treating, and preventing diseases. In this context, it stresses the importance of proper medication management for Parkinson's disease, particularly understanding how drug treatments can combat symptoms while managing the risks of potential side effects.
10) Relative:
Relative refers to the close family members or caregivers of patients from whom data was collected during the study. Their input is vital for understanding the patient's clinical history and symptoms, thereby aiding in the accurate assessment of the disease's progression and treatment efficacy.
11) Quality:
Quality denotes the standard of care and treatment provided to patients with Parkinson's disease. The study aims to enhance the quality of pharmacological management by identifying effective prescribing trends and understanding the risks associated with long-term medication use, ultimately improving patient outcomes.
12) Filling (Filled):
Filling in this context could relate to the idea of bridging the gap between clinical practice and research, particularly in understanding levodopa-induced dyskinesia. It emphasizes the necessity to integrate findings from the study into practical applications for managing Parkinson's disease effectively.
13) Thomas:
Thomas refers to Teena Thomas, one of the authors and contributors in this research study from Pushpagiri College of Pharmacy. Her involvement underlines the collaborative nature of academic research in enhancing the understanding of Parkinson's disease through shared expertise among pharmacy and medical professionals.
14) Debate:
Debate signifies the ongoing discussions surrounding the management of Parkinson's disease, particularly concerning treatment effects such as dyskinesia arising from levodopa usage. It reflects the need for continued inquiry into optimal therapeutic strategies and the risks versus benefits of existing treatment modalities.
15) Trade:
Trade may pertain to the pharmaceutical trade which involves the distribution and commercialization of anti-Parkinson drugs. Understanding the dynamics of this sector can help improve access to vital medications necessary for managing Parkinson's disease, influencing prescribing practices and patient adherence.
16) Table:
Table likely refers to the presented data within the study that illustrates the associations between various patient variables and dyskinesia related to levodopa treatment. It serves as an important visual representation of findings, facilitating easier comprehension of research outcomes and statistical analysis.
17) Sign:
Sign relates to the symptoms or indicators of Parkinson's disease that are critical for diagnosis and treatment decisions. Understanding these signs helps in evaluating the progression of the disease, allowing healthcare providers to adjust treatment plans effectively based on patient responses.
18) Life:
Life in this context may refer to the quality of life experienced by patients with Parkinson's disease, which can be significantly impacted by their symptoms and treatment responses. Effective management through identified drug patterns aims to enhance the overall life quality for these patients.