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Running Header: PARKINSON’S DISEASE

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PARKINSON’S DISEASE

PARKINSON’S DISEASE

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Parkinson’s disease refers to a continuous disarray of the sensory system. This condition is caused by the genes or environmental factors. There are certain genes that tend to increase the risk of contracting this condition and some environmental factors though their chances are small. This disorder majorly affects motion or movement. It does this by altering the neurocytes that are found in the black substance. The neurons are responsible for the transfer of nerve impulses from the corpus collosum to the middle of the brain particularly the black substance. These neurocytes are responsible for the voluntary movement of the body. This disorder is majorly experienced by elderly people. In most cases it is causes by excessive usage of medications and the environmental factors (Ahlskog, 2018). The Parkinson’s disease has the following signs and symptoms;

· Tremor- A patient suffering from this condition will experience body shaking, and in most cases, it happens at the hands. In this case the handshakes while still at rest.

· Slow movements- this condition slows down the patient’s movements such that doing simple tasks becomes a challenge. It leads to a lot of time consuming.

· Muscles become rigid- it makes muscles from different parts of the body become stiff. This causes pain to the patient and reduces his or her movements.

· Imbalance- One may experience impaired posture and balance. One finds it very difficult to stand upright and sometimes he or she may fall.

· Impairment of automatic movements- Actions like blinking, smiling and swinging of hands by default become a challenge. One is not able to automatically perform these functions effectively.

· Change of speech-This condition affects and alters the patient’s nature and way of speaking. The patient may start speaking slowly, softly or even quickly. The speech may become a monotone rather that with its normal inflections.

· Changes in writing- A Parkinson’s patient may find it very difficult to write and in most cases the handwriting becomes very small. Tremor may also cause the handwriting to be shoddy and one’s hand will not be stable and still while writing.

Prescription

Parkinson’s disease cannot be cured. Medications are often used to mitigate the symptoms of this disease. Sometimes, medical practitioners recommend change of lifestyle especially bodily exercise. To improve on one’s speech, it is recommended to seek speech pathologist. The following medications could be very useful to a patient suffering from Parkinson’s disease;

· Carbidopa- It is the best medication for this condition. It is an enzymatic substance which gets into the brain and changes into Intropin. L-dopa is used together with carbidopa which prevents L-dopa from being converted into Intropin before reaching the brain. It also reduces the aftermath of L-dopa such as nausea. After several years of usage of this drug, it will start to have less impact on your body. One will also start incurring involuntary movements if taken in large doses hence the need for regular control from time to time by the doctor (Mayo Clinic, 2020).

· Carbidopa-Levodopa infusion- it is given via a tube that delivers the medication straight into the small intestine in the form of a gel. This medication is for patients whose disease is more advanced, though they respond to Carbidopa-Levodopa, the response is not stable. S small surgery is needed to install the tube. Having this tube exposes one to infections or sometimes the tube may fall out (Mayo Clinic, 2020).

· Dopamine agonist-this medication remains the same but it borrows the brain outcome of dopamine. They are not as strong as Levodopa but they can be used together with it to smoothen the results of L-dopa. Samples of dopamine agonists are ropinirole, pramipexole etc. The side effects of this medication are similar to those of carbidopa-Levodopa but they extend to hallucinations and sleepiness (Mayo Clinic, 2020).

· MAO B inhibitors- They inhibit the brain enzyme, monoamine oxidase B, helping in the prevention of breakdown of the brain dopamine. They include selegiline, Rasagiline and safinamide. Its side effects include nausea and insomnia. If this medication is used together with Carbidopa-Levodopa, chances of hallucinations will increase (Mayo Clinic, 2020).

· COMT inhibitors- This medication lengthens the effect of Levodopa by standing in the way of an enzyme that that causes breakdown of dopamine. An example of this inhibitor is the entacapone. Side effect of these inhibitors includes diarrhea and involuntary movements. Tolcapone is also a COMT inhibitor but it is hardly prescribed because of its serious effects on the liver (Mayo Clinic, 2020).

· Anticholinergics- They has been in use for quite a number of years and they are used to control Parkinson’s disease tremor. One example of this medication is benztropine. Its side effects include confusion, dry mouth, memory loss and constipation (Mayo Clinic, 2020).

· Amantadine- It offers short time relief. They may be given together with carbidopa-Levodopa to control the involuntary movements caused by carbidopa-Levodopa. Its side effects include hallucinations and ankle swelling (Mayo Clinic, 2020).

Adverse effects and drug-drug interaction

Sometimes, a drug may be used to treat one disease but end up causing another disease if not carefully taken. It may be a drug for one disease but when used inappropriately, it may become a virus or bacteria that will cause a different disease. When it comes to depression, there are drugs that can treat it but may end up causing Parkinson’s disease. Treatment of Alzheimer’s could also lead to Parkinson’s disease symptoms. Sleepiness and hallucinations are the most common symptoms of Parkinson’s disease. In drug-drug interaction, warfarin has a severe effect as it causes insolubility of the drug and ends up reducing the interaction of the drug with the plasma serum (Katzenschlager et.al, 2018).

Pediatrics and geriatrics

It has been noted that there are many changes that occur in the life of a child up to puberty. This has led to the need for pediatric groupings. There are still a lot to discover in the psychological development and it can only be achieved if these findings are brought about according to the groups. Children and adults have different reactions or responses to treatments. For example, phenobarbitones are very critical and important in the treatment of cerebral malaria amongst adults. But the same medication, if administered to children, then it is likely to cause mortality. The same way corticosteroid can be used by adults with meningitis, but not with children with the same condition. There is no adequate guideline that has been put in place to cater for the analysis of these age groups and the psychological experiences involved at each group.

Geriatrics is not only for the old as the case may be inferred by the majority of the people; it could also be very important and vital for persons who are below the age of sixty. It is not only geriatricians who can offer geriatrics care; anyone can connect these seniors to a healthcare that is meant for the aging minds and bodies. Breast feeding mothers must have a controlled dosage of Parkinson’s disease medication if at all they are suffering from the disease. Medications like ropinirole have adverse effects on children as they may cause mood swings and malfunctioning of the body parts. Elderly patients should do slow bodily exercises to improve their body movements. Geriatrics comes in hand in improving the dopamine levels in the body of an elderly patient (Katzenschlager et.al, 2018).

References

Mayo Clinic. (2020). The Parkinson’s Disease. Retrieved from https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/diagnosis-treatment/drc-20376062.

Ahlskog, J. E. (2018, March). Aerobic exercise: evidence for a direct brain effect to slow

Parkinson disease progression. In Mayo Clinic Proceedings (Vol. 93, No. 3, pp. 360-372). Elsevier. Retrieved from https://mail.google.com/mail/u/0/#inbox/FMfcgxwGDWvBxdQgtkVStCGSBRhgqzMT?projector=1&messagePartId=0.1.

Katzenschlager, R., Poewe, W., Rascol, O., Trenkwalder, C., Deuschl, G., Chaudhuri, K. R., ... & Staines, H. (2018). Apomorphine subcutaneous infusion in patients with Parkinson's disease with persistent motor fluctuations (TOLEDO): a multicenter, double-blind, randomized, placebo-

controlled trial. The Lancet Neurology, 17(9), 749-759. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S1474442218302394.