Represented by SHIVAJI SINGH

SAMEER CHAVAN SOURIMA

MUKHERJEE SONAL KULKARNI

SUVARNA CHAVAN

M.Sc (CLINICAL RESEARCH)

(CRANFIELD)GROUP-9

Neuro-degenerative disorder.

caused by a deficiency of dopamine and an excess of acetylcholine within the CNS.

Affects the part of the brain that controls muscle movement, causing symptoms as trembling, rigidity.

Multidisciplinary management is essential

1. Drug therapy2. Physiotherapy3. Occupational therapy4. Speech and language therapy5. Nursing6.Surgical treatment7.Gene therapy

Divided into two broad classes:

1. Dopaminergic drugs

2. Anticholinergic drugs

Divided into six sub classes

1. Dopaminergic precursor -levodopa

2. Peripheral decarboxylase inhibbtor -carbidopa -benserazide

3. MAO-B inhibitor -selegiline -rasagiline

4. Dopamine agonists

4.1. ERGOT DERIVATIVES 4.2. NON ERGOT DERIVATIVES

-lusiride -piribedil -bromocriptine -rotigotin -pregolide -ropinirole

5. Dopamine facilitator -amantadine

6. COMT inhibitor (catechol-O-methyltransferase) -entacapone -tolcapone

No change in muscle tone.

Reversal of tremor requires continued therapy.

Changes in mood associated with parkinsonism are reversed.

95% of l-dopa is metabolized in the periphery to dopamine.

Only a small portion entering the brain.

Choreiform or dystonic movements, anorexia, abdominal pain, dysphagia, dry mouth, mental changes, headache, dizziness, increased hand tremor, peripheral edema, constipation hallucinations, confusion, depression, loss of balance

Contraindicated in patients with narrow-angle glaucoma,those receiving a monoamine oxidase inhibitor.

Used with caution in patients with tachycardia, cardiac arrhythmias, hypertension, hypotension.

Cautious administration in patients with obstructive disease of the urinary system or gastrointestinal tract.

Divided into two sub classes

1. Anticholinergic drugs -benztropine -procyclidine -biperiden

2. Antihistamines drugs -diphenhydramine -orphenadrine -promethzine

Inhibit acetylcholine in the CNS.

Less effective than levodopa.

Dry mouth, blurred vision, dizziness, mild nausea, and nervousness.

Skin rash, urinary retention, tachycardia, muscle weakness, disorientation, and confusion.

Contraindicated in patients with a hypersensitivity to the drugs and during pregnancy and lactation

The COMT inhibitors are used with caution in patients with hypertension,hypotension, and decreased hepatic or renal function

Gives advice and helps maintaining all aspects relating to activities of daily living.

both at work and at home, with the aim of maintaining work and family relationships, encouraging self-care where appropriate.

To help improve gait, balance and flexibility

Improve aerobic activity and movement initiation

Increase independence and provide advice re fall prevention and other safety information.

improving loudness and intelligibility of speech where possible.

Ensuring methods of communication are available as the disease progresses and to help with swallowing.

Observe the patient's mood, cognition; organization and general well being.

Observe for features of depression

Patients should not be forced into situations in which they feel ashamed of their appearance.

Encourage the patient to participate in moderate exercises.

Relaxation therapy

Deep brain stimulation

Connected to pacemaker which delivers a constant current.

Is safe and efficacious.

Mutations in the LRRK2, PARK2, PARK7, PINK1, and SNCA genes cause Parkinson disease.

Stem cell therapy hold the promise of treating disease by

growing new tissues and organs from stem cells .

Lisuride Patch to Treat Parkinson's Disease

This study has been completed In August 6, 2004   Last Updated: October 25, 2007

Sponsor: National Institute of Neurological Disorders and Stroke (NINDS)

Information provided by: National Institutes of Health Clinical Center (NIHCC)

www.newyorktimes.com

http://www.ncbi.nlm.nih.gov/pubmed/17969557Current ene Ther. 2007 Aug;7(4):239-48

http://www.nature.com/news/full/news.html