Post on 18-Feb-2019
transcript
Effetti collaterali della bromocriptina e dei derivati ergolinici
edema agli arti inferiori
fibrosi pleuropolmonari, pericardiali, valvolari e retroperitoneali
sonnolenza
comportamenti impulsivi/compulsivi (5%)
Agonisti diretti recenti dei recettori dopaminergic i
Rotigotina preparazione transdermica Problemi con la cristallizzazione locale della rotigo tina e reazioni locali, ne limitano l’uso
Anticolinergici(tremore rigidità muscolare)
�Orfenadrina �Triesifenidile�Biperidene�Metixene�Bornaprina
�Effetti collaterali:�offuscamento vista�secchezza fauci�ritenzione urinaria�costipazione�memoria, confusione mentale
3 METOSSITIRAMINA
L-DOPA
DDC
DOPAMINA
L-DOPA
TIROSINA
TH
DA
DDC
BEE
DACOMT
DAT
DAR
MAO-B
DOPAC
agonisti DA
COMT
3-O-METIL-DOPA
selegilinarasagilina DOPAMINA
�Neurology. 2003 Aug 12;61(3):293-6.Adenosine A(2A) receptor antagonist treatment of Pa rkinson's disease.
Bara-Jimenez W, Sherzai A, Dimitrova T, Favit A, Bibbiani F, Gillespie M, Morris MJ, Mouradian MM, Chase TN.Istradefylline in patients with dyskinesia and motor fluctuation.
No improvement when administered alone or in association with optimal dose of L-DOPA. Improvement when administered in association with sub-optimal dose of L-DOPA, similar to optimal dose of L-DOPA but less dyskinesia and increase in L-DOPA duration. Improvement in tremor, rigidity and bradykinesia� Neurology. 2003 Aug 12;61(3):297-303.Randomized trial of the adenosine A(2A) receptor an tagonist istradefylline in advanced PD.Hauser RA, Hubble JP, Truong DD; Istradefylline US-001 Study Group.In patients with dyskinesia and motor fluctuation. Reduction of OFF time, increase in non-troublesome dyskinesia
�Ann Neurol. 2008. Adenosine A(2A) receptor antagonist istradefylline ( KW-6002) reduces "off" time in Parkinson's disease: A double -blind, randomized, multicenter clinical trial (6002-US-005)Lewitt PA, Guttman M, Tetrud JW, Tuite PJ, Mori A, Chaikin PC, et al.
� Neurology. 2008; 70(23):2233-40. A 12-week, placebo-controlled study (6002-US-006) of istradefylline in Parkinson disease. Stacy M, Silver D, Mendis T, Sutton J, Mori A, Chaikin P, et al. � Mov Disord . 2008. Hauser R, Shulman LM, Trugman JM, Roberts JW, Mori A, Ballerini R, et al. Study of istradefylline in patients with Parkinson’s disease on levodopa with motor fluctuations.� Mov Disord. 2006;21(Suppl 15):S585. Guttman M. Efficacy of istradefylline in Parkinson’s diease patients treated with levodopa with motor response complications: results of the KW-6002 US-018 study.� Mov Disord . 2008 Vol. 23, Suppl. 1: S87. Fernandez HH. The safety and efficacy of istradefylline, an adenosine A2A antagonist, as monotherapy in Parkinson’s disease: Results of the KW-6002-US-051 trial.