title: Infusion treatments and deep brain stimulation in Parkinson's Disease: The role of nursing.
abstract: Parkinson's Disease (PD) represents one of the most common neurodegenerative disorders in the elderly. PD is caused by a loss of dopaminergic cells in the substantia nigra pars compacta. The motor cardinal signs include a resting tremor, bradykinesia, rigidity and postural reflex impairment. Although levodopa represents the gold standard also in the advanced stage of the disease, over the years most patients develop disabling motor fluctuations, dyskinesias, and non-motor complications, which are difficult to manage. At this stage, more complex treatment approaches, such as infusion therapies (subcutaneous apomorphine and intraduodenal levodopa) and deep brain stimulation of the subthalamic nucleus or the globus pallidus internus should be considered. All three procedures require careful selection and good compliance of candidate patients. In particular, infusional therapies need adequate training both of caregivers and nursing staff in order to assist clinicians in the management of patients in the complicated stages of disease.
authors.affiliation: Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, via Pansini 5, 80131 Naples, Italy. Electronic address: anna.derosa1@unina.it.
authors.forename: Anna
authors.initials: A
authors.lastname: De Rosa
authors.affiliation: Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Tessitore
authors.affiliation: Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, via Pansini 5, 80131 Naples, Italy.
authors.forename: Leonilda
authors.initials: L
authors.lastname: Bilo
authors.affiliation: Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, via Pansini 5, 80131 Naples, Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Peluso
authors.affiliation: Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, via Pansini 5, 80131 Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Michele
mesh_terms: D000978:Antiparkinson Agents / Q000627:therapeutic use; D001058:Apomorphine / Q000627:therapeutic use; D046690:Deep Brain Stimulation / Q000379:methods / Q000451:nursing; D004639:Emetics / Q000009:adverse effects / Q000627:therapeutic use; D018718:Home Infusion Therapy / Q000379:methods / Q000451:nursing*; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D024802:Nurse's Role; D010300:Parkinson Disease / Q000188:drug therapy / Q000451:nursing
chemical_list: D000978:Antiparkinson Agents; D004639:Emetics; D007980:Levodopa; D001058:Apomorphine
keywords: Advanced treatment; Deep brain stimulation; Nursing; Parkinson's Disease