Question

• Discuss the pharmacological treatment of clients with Parkinson’s disease. Describe the therapeutic effect of levodopa, carbidopa, anticholinergics. Discuss the on-off phenomenon and drug holidays.

Answer 1

The treatment of Parkinson's includes mainly carbidopa-levodopa. Levodopa medication is most effective as the brain cell convert it to dopamine. Scientists have developed new drugs for Parkinson's disease in recent years.

Dopamine is the brain is responsible for the body movements. People with Parkinson's disease will not have sufficient dopamine in their body. By using levodopa, the patient can make improvements with this extra dopamine. It helps in the movement of rigid body parts. Carbidopa is efficiently used with levodopa in order to reduce the side effects. It prevents vomiting, increased heart rates etc.

Anticholinergics prevents the action of acetylcholine which is a neurotransmitter. It can be helpful in Parkinson's disease also as it will block involuntary muscle movements, a common problem associated with Parkinson's disease. The term drug holidays are well known in HIV therapy. The patient stops his/her medications for a period of time that varies from days to months or even years. Sometimes it will be helpful to strengthen the immune system.

The on-off phenomenon is a common problem associated with Parkinson's disease. For some patients, the effect of the medication will not last for more than a few hours. After medication, they may feel better and this is called 'on' state and soon after they are changes to the worst state called 'Off' state indicating the due of next medication. This on-off phenomenon is predictable in some patients and for some others, it is unpredictable.