[Medicinal treatment of idiopathic Parkinson's disease].
Idiopathic Parkinson's disease (IPD) results from a largely selective degeneration of nigrostriatal dopaminergic neurons. Therefore, compounds which strengthen dopaminergic transmission in the striatum are the most important therapeutic approach. These include L-dopa, dopamine receptor agonists, selegeline, and entacapon. Since nigrostriatal degeneration leads to secondary alterations of cholinergic and glutamatergic transmission to the basal ganglia,nondopaminergic compounds such as anticholinergics and N-methyl-D-aspartate (NMDA) receptor antagonists are also used in the management of IPD. L-dopa is the most effective substance but after 3-5 years of L-dopa treatment, approximately half of all IPD patients develop fluctuations. Therefore, initial treatment with a dopamine receptor agonist is recommended.
Klockgether
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Neurologische Klinik, Universität Bonn.
D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018680:Cholinergic Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D003342:Corpus Striatum / Q000187:drug effects; D004298:Dopamine / Q000378:metabolism; D018491:Dopamine Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007980:Levodopa / Q000009:adverse effects / Q000627:therapeutic use; D009434:Neural Pathways / Q000187:drug effects; D010300:Parkinson Disease / Q000188:drug therapy*; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors; D013378:Substantia Nigra / Q000187:drug effects; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D018680:Cholinergic Antagonists; D018491:Dopamine Agonists; D016194:Receptors, N-Methyl-D-Aspartate; D007980:Levodopa; D004298:Dopamine