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Antiparkinsonian Drugs (antiparkinsonian + drug)
Selected AbstractsEstimation of incidence and prevalence of Parkinson's disease in the elderly using pharmacy recordsPHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 6 2001D. A. M. C. van de Vijver PharmD Abstract Purpose We determined the prevalence and incidence of Parkinson's disease among persons aged 55 years and older in pharmacy records. Methods Data came from the PHARMO database which includes information on drug dispensing for all residents of six Dutch cities. We selected all persons aged 55 years and older who had used antiparkinsonian drugs, and calculated a chance for having Parkinson's disease with use of a previously validated logistic regression model. We used a cut-off of 0.5 (sensitivity 62%, positive predictive value 92%). Prevalence was estimated on the first Wednesday of October 1997, incidence on the first Wednesday of October 1993 until 1997. A patient was incident, if the first prescription for an antiparkinsonian drug was dispensed at least 180 days after entry into PHARMO. Prevalence and incidence were standardized to the Netherlands population of 1 January 1998. The prevalence was adjusted for the sensitivity and positive predictive value of the model. Results The unadjusted prevalence (per 100 000) for those aged 55,64 years was 111, 65,74 years 598, 75,84 years 1551 and for persons aged 85 years and older 1847. The adjusted and standardized prevalence was 970 per 100 000 (95% confidence interval 869 to 1071). The incidence (per 100 000 person years) for persons aged 55,64 years was 12, 65,74 years 108, 75,84 years 257 and for persons aged 85 years and older 247. The standardized incidence was 109 per 100 000 person years (96 to 121). Conclusions Prevalence and incidence were in range with the literature. Pharmacy records therefore seem to be a useful tool for continuous monitoring of incidence and prevalence of Parkinson's disease. Copyright © 2001 John Wiley & Sons, Ltd. [source] Interindividual variation of serum haloperidol concentrations in Japanese patients , clinical considerations on steady-state serum level,dose ratiosJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 2 2003E. Yukawa Summary Objective:, Marked interpatient variability in haloperidol (HAL) level,dose (L/D) ratios makes it difficult to use the administered dose for predicting serum concentrations. Objective:, To investigate the effect of dose, age, total body weight and co-medication on steady-state HAL L/D ratios. Method:, Retrospective analysis of dose and HAL blood level data from 168 patients. Results:, The HAL L/D ratio decreased curvilinearly with increasing daily dose of HAL. The patients treated with concomitant antiparkinsonian drugs showed a mean HAL L/D ratio that was 24·9% higher than those without antiparkinsonian drugs. The patients treated with concomitant antiepileptic drugs showed a mean HAL L/D ratio that was 27·2% lower than those without antiepileptic drugs. The mean HAL L/D ratio of patients treated with concomitant CYP2D6 substrates was not significantly different from those without CYP2D6 substrates. Conclusion:, There is a wide interindividual variability in blood levels of HAL in patients given the same dose. Routine monitoring of HAL serum level is useful, especially in patients who require associated antiepileptic and/or antiparkinsonian medication. [source] Four-week trunk-specific rehabilitation treatment improves lateral trunk flexion in Parkinson's disease,MOVEMENT DISORDERS, Issue 3 2010Michelangelo Bartolo MD Abstract People with Parkinson's disease (PD) often have a posture characterized by lateral trunk flexion poorly responsive to antiparkinsonian drugs. To examine the effects of a rehabilitation programme (daily individual 90-minute-sessions, 5-days-a-week for 4-consecutive weeks) on lateral trunk flexion and mobility, 22 PD patients with mild to severe lateral trunk flexion, and 22 PD patients without trunk flexion were studied. Patients were evaluated using the Unified Parkinson's Disease Rating Scale motor subscale (UPDRS-III) score, and the kinematic behavior of the trunk was recorded by means of an optoelectronic system to determine: a) trunk flexion, inclination and rotation values in the erect standing posture; b) ranges of trunk flexion and inclination during trunk movements. After the treatment, significant decreases in trunk flexion [24°(4) vs. 14°(3), P < 0.001] and inclination in the static condition [23°(5) vs. 12°(4), P < 0.001)] were observed, both of which were maintained at the 6-month follow up. During the trunk flexion task, a significantly increased range of trunk flexion [64°(15) vs. 83°(15), P < 0.001] was observed; similarly, during the lateral bending task, the range of trunk inclination was found to be significantly increased, both toward the side of the trunk deviation [29°(8) vs. 42°(13), P < 0.01] and toward the contralateral side [14°(6) vs 29°(11), P < 0.01]. No further significant changes were observed at the 6-month follow-up. Trunk flexion and inclination values in the upright standing posture correlated slightly with the UPDRS-III score. Our findings show that significant improvements in axial posture and trunk mobility can be obtained through the 4-week rehabilitation programme described, with a parallel improvement in clinical status. © 2010 Movement Disorder Society [source] The power of cueing to circumvent dopamine deficits: A review of physical therapy treatment of gait disturbances in Parkinson's diseaseMOVEMENT DISORDERS, Issue 6 2002Tamar C. Rubinstein MSc Abstract Gait disturbances are among the primary symptoms of Parkinson's disease (PD) and contribute significantly to a patient's loss of function and independence. Standard treatment includes antiparkinsonian drugs, primarily levodopa. In addition to the standard drug regime, physical therapy is often prescribed to help manage the disease. In recent years, there have been promising reports of physical therapy programs combined with various types of sensory cueing for PD. In this brief review of the literature, we summarize the evidence regarding the clinical efficacy of different physical therapy programs for PD, specifically with respect to improving gait. We also discuss the potential therapeutic mechanisms of sensory cueing and review the studies that have used cueing in the treatment of gait in PD. This review of the literature shows two key findings: (1) despite its relatively long history, the evidence supporting the efficacy of conventional physical therapy for treatment of gait in PD is not strong; and (2) although further investigation is needed, sensory cueing appears to be a powerful means of improving gait in PD. © 2002 Movement Disorder Society [source] Estimation of incidence and prevalence of Parkinson's disease in the elderly using pharmacy recordsPHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 6 2001D. A. M. C. van de Vijver PharmD Abstract Purpose We determined the prevalence and incidence of Parkinson's disease among persons aged 55 years and older in pharmacy records. Methods Data came from the PHARMO database which includes information on drug dispensing for all residents of six Dutch cities. We selected all persons aged 55 years and older who had used antiparkinsonian drugs, and calculated a chance for having Parkinson's disease with use of a previously validated logistic regression model. We used a cut-off of 0.5 (sensitivity 62%, positive predictive value 92%). Prevalence was estimated on the first Wednesday of October 1997, incidence on the first Wednesday of October 1993 until 1997. A patient was incident, if the first prescription for an antiparkinsonian drug was dispensed at least 180 days after entry into PHARMO. Prevalence and incidence were standardized to the Netherlands population of 1 January 1998. The prevalence was adjusted for the sensitivity and positive predictive value of the model. Results The unadjusted prevalence (per 100 000) for those aged 55,64 years was 111, 65,74 years 598, 75,84 years 1551 and for persons aged 85 years and older 1847. The adjusted and standardized prevalence was 970 per 100 000 (95% confidence interval 869 to 1071). The incidence (per 100 000 person years) for persons aged 55,64 years was 12, 65,74 years 108, 75,84 years 257 and for persons aged 85 years and older 247. The standardized incidence was 109 per 100 000 person years (96 to 121). Conclusions Prevalence and incidence were in range with the literature. Pharmacy records therefore seem to be a useful tool for continuous monitoring of incidence and prevalence of Parkinson's disease. Copyright © 2001 John Wiley & Sons, Ltd. [source] | ||||||||||