Presentation
The patient presented with persistent high fever, stupor, autonomic dysfunction, rigidity, and rhabdomyolysis. He was successfully treated with intravenous dantrolene, resumption of levodopa, and forced alkaline diuresis. [ncbi.nlm.nih.gov]
Many of the adverse effects that are present with Levodopa are due to the fact that it is not combined with a partner drug. [physio-pedia.com]
Gastrointestinal
- Diarrhea
Entacapone (Stalevo®) 12.5/50/200 mg 18.75/75/200 mg 25/100/200 mg 31.25/125/200 mg 37.5/150/200 mg 50/200/200 mg 12.5/50/200 mg Nausea, vomiting, falling blood pressure upon standing, worsening of glaucoma, dyskinesia, hallucination, psychosis, dyskinesia, diarrhea [parkinson.org]
Sinemet Side Effects Common Side Effects of Sinemet Tell your doctor if any of the following side effects become severe or don't go away: Nausea Dizziness Vomiting, diarrhea, or constipation Loss of appetite Dry mouth Change in taste Confusion or forgetfulness [everydayhealth.com]
[…] syndrome.[5] There is tentative evidence that it is useful in amblyopia when used with other treatments.[12] Side effects[edit] Common side effects include dizziness, drowsiness, blurred vision, vomiting, nausea, dry mouth, low appetite, heartburn, diarrhea [en.wikipedia.org]
Call your doctor at once if you have: uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement); worsening of tremors (uncontrolled shaking); severe or ongoing vomiting or diarrhea; confusion [uwhealth.org]
- Delayed Gastric Emptying
However reduced benefit from a dose, earlier wearing off from a previously effective dose and decreased duration of benefit from a dose are less likely to be due to delayed gastric emptying and accounted for the majority of patients effects (79 %) in [clinicalmovementdisorders.biomedcentral.com]
Cardiovascular
- Tachycardia
- Tachycardia and arrhythmias. - Discoloration of urine. - Psychiatric symptoms. - Headaches. - Increased sweating. - Change in sense of taste. - Gastrointestinal bleeding. [nursingtimes.net]
Doses of a few grams may result in CNS disturbances, with an increasing likelihood of cardiovascular disturbance (e.g., hypotension, tachycardia) and more severe psychiatric problems at higher doses. [rytaryhcp.com]
[…] and ventricular extrasystoles, atrial flutter and fibrillation, and ventricular tachycardia have been reported. [inchem.org]
The HR variability in the Valsalva tests was expressed as the ratio of the maximum tachycardia to the maximum bradycardia induced by the maneuver during the 30 seconds following the release of the strain (Valsalva ratio) ( 13 ). [academic.oup.com]
Skin
- Alopecia
Thus, levodopa decrease the secretion of prolactin while dopaminergic antagonists have an opposite effect (Goodman & Gilman, 1986). 9.4.8 Dermatological Some patients developed diffuse alopecia (Martindale, 1989). 9.4.9 Eye, ear, nose throat: local effects [inchem.org]
Neurologic
- Confusion
Carbidopa/levodopa Immediate Release Tablets (Sinemet) Available Doses: 10/100 mg, 25/100 mg, 25/250 mg Typical Treatment Regimen: 150–1000 mg of levodopa total/day (divided 3-4 times) Common Side Effects: Low blood pressure, nausea, confusion, dyskinesia [parkinson.org]
Hallucinations may be accompanied by confusion, insomnia, and excessive dreaming. [rytaryhcp.com]
Chances of falling asleep during normal activities increases if you take medicine that cause sleepiness. withdrawal-emergent hyperpyrexia and confusion (fever, stiff muscles, or changes in breathing and heartbeat) if you suddenly stop using INBRIJA or [acorda.com]
There is an increased risk for hallucinations, psychosis, and confusion in patients taking DUOPA. Hallucinations associated with levodopa may present shortly after the initiation of therapy and may be responsive to dose reduction of levodopa. [duopapro.com]
- Abnormal Involuntary Movement
‘Although levodopa remains the optimal treatment for Parkinson's disease, ropinirole provides similar improvements in functional abilities while minimising abnormal involuntary movements.’ [en.oxforddictionaries.com]
Tell your healthcare provider if abnormal involuntary movements appear or get worse during treatment with RYTARY. [rytary.com]
Report promptly abnormal involuntary movement such as facial grimacing, exaggerated chewing, protrusion of tongue, rhythmic opening and closing of mouth, bobbing of head, jerky arm and leg movements, and exaggerated respiration. [robholland.com]
Involuntary movements are very common and usually start in the mouth, jaws or tongue. Abnormal limb movements often develop after several months and severe choreoathetoid movements may also occur after prolonged high doses. [inchem.org]
Abnormal involuntary movements manifested by patients with dyskinesia may contribute to the establishment of swallowing abnormalities in the PD 17. [scielo.br]
- Myoclonus
Several movement disorders can occur as adverse effects of levodopa therapy, eg, choreoathetosis, dystonia, akathisia, myoclonus, tremor, and dyskinesias. [medlink.com]
They are characterized for being abnormal, and mainly for affecting the extremities (among them, the jaw) showing motor adjustments of the choreiform type, dystonia, athetosis, tics and myoclonus 32. [scielo.br]
- Choreoathetoid Movements
Involuntary movements are very common and usually start in the mouth, jaws or tongue. Abnormal limb movements often develop after several months and severe choreoathetoid movements may also occur after prolonged high doses. [inchem.org]
Workup
Workup, including brain, cervical, thoracic, and lumbar spine magnetic resonance imaging and paraspinal muscle electromyography, was unremarkable. Serum ceruloplasmin level was normal. [ncbi.nlm.nih.gov]
Serum
- Homocysteine Increased
INTRODUCTION: Homocysteine increase and glutathione derivative cysteinyl-glycine fall are indirect biomarkers for oxidative stress, for instance due to dopamine D 1 receptor stimulation. [ncbi.nlm.nih.gov]
Treatment
Fourteen patients (36.8%) maintained the LCAS treatment after 12months, and were categorized as the treatment-retention group. [ncbi.nlm.nih.gov]
Treatment Parkinson's Disease (PD) 1 2 Recruiting Treatment ASD 1 2 Recruiting Treatment Age-Related Macular Degeneration (ARMD) 1 2 Recruiting Treatment Albinism / Albinism, Oculocutaneous 1 2 Recruiting Treatment Idiopathic Parkinson's Disease 1 2 [drugbank.ca]
The PLMSI showed markedly larger improvement with levodopa treatment whereas treatment effects of total sleep time did not differ from placebo treatment. [doi.org]
Prognosis
Prognosis Disease progression rate and severity is highly variable. The main predictor of prognosis is the rate of decline in pulmonary function with sporadic LAM generally more severe than TSC-LAM. [orpha.net]
Article in Polish | MEDLINE | ID: mdl-21678282 Similar Index: MEDLINE Main subject: Tuberculosis, Pulmonary / Tuberous Sclerosis / Lymphangioleiomyomatosis Type of study: Case report Clinical aspect: Diagnosis / Prognosis Limits: Adult / Female / Humans [pesquisa.bvsalud.org]
9.1.1 Ingestion 9.1.2 Inhalation 9.1.3 Skin exposure 9.1.4 Eye contact 9.1.5 Parenteral exposure 9.1.6 Other 9.2 Chronic poisoning 9.2.1 Ingestion 9.2.2 Inhalation 9.2.3 Skin exposure 9.2.4 Eye contact 9.2.5 Parenteral exposure 9.2.6 Other 9.3 Course, prognosis [inchem.org]
Diagnosis Aims are to communicate information about the disease, help the patient accept the diagnosis, reduce distress and minimise symptoms and, ultimately, improve prognosis. [patient.info]
This is because the evaluation, prognosis, conduct and therapeutic evolution will possess basement and deeper study. [scielo.br]
Etiology
Despite extensive investigations, the etiology of her basal ganglia lesions remained nebulous. The patient's dystonia responded to Trihexyphenidyl and to tetrabenazine, but these medications needed to be stopped because of side effects. [ncbi.nlm.nih.gov]
Still the only major text on the subject, the completely revised and updated second edition of Parkinson's Disease: Diagnosis and Clinical Management comes at a time when specialists have made important advances in our understanding of the etiology, pathogenesis [books.google.com]
Epidemiology
Author information 1 Neurosciences, Alfred Hospital, Melbourne, Victoria, Australia. 2 Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 3 Clinical Haematology [ncbi.nlm.nih.gov]
Goitre epidemiology: Thyroid volume, iodine excretion, thyroglobulin and thyrotropin in Germany and Sweden. Acta Endocrinol 1 12:494501. [books.google.ro]
Summary Epidemiology Sporadic LAM affects around 1/500,000-1/125,000 adult women in Europe. TSC is present in 1 in 6,000 births. Pulmonary LAM is present in up to 30-40% of adult TSC cases. LAM affects almost exclusively females. [orpha.net]
Epidemiology of Parkinson’s disease. Parkinsonism Relat Disord. 1997;3(4):175–86. CrossRef PubMed Google Scholar 8. Zhang ZX, Roman GC, Hong Z, Wu CB, Qu QM, Huang JB, Zhou B, Geng ZP, Wu JX, Wen HB, Zhao H, Zahner GE. [link.springer.com]
Author Affiliations From the Department of Neurology, Amsterdam Neuroscience (C.V.M.V., S.R.S., J.A.B., R.M.A.B.), Clinical Epidemiology, Biostatistics, and Bioinformatics (M.G.W.D.), and the Clinical Research Unit (R.J.H.), Amsterdam UMC, University [nejm.org]
Pathophysiology
Gait analysis proves to be an effective tool to understand the pathophysiology of this patient, the therapeutic effects and mild residual gait defects in order to plan further rehabilitation strategy for this DRD patient. [ncbi.nlm.nih.gov]
The pathophysiology of levodopa-induced motor complications is likely due to a combination of disease-related factors, as well as the pharmacokinetics of levodopa itself. [brain.oxfordjournals.org]
Gastrointestinal dysfunction in Parkinson's disease: frequency and pathophysiology. [scielo.br]
Postprandial hypotension: epidemiology, pathophysiology, and clinical management. Ann Intern Med. 122 : 286 -295. 3 Meco G, Pratesi L, Bonifati V, 1991. Cardiovascular reflexes and autonomic dysfunction in Parkinson's disease. [academic.oup.com]
Prevention
Author information 1 Neurosciences, Alfred Hospital, Melbourne, Victoria, Australia. 2 Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 3 Clinical Haematology [ncbi.nlm.nih.gov]
Alendronate slows bone loss while increasing bone mass, which may prevent bone fractures. Alendronate is used to treat or prevent postmenopausal osteoporosis and steroid-induced osteoporosis. [emedicinehealth.com]
This inhibitor prevents the metabolisation of the L-dopa before entering the CNS. [flexikon.doccheck.com]
The carbidopa prevents the levodopa from being broken down in the periphery. [quizlet.com]