Tags

Type your tag names separated by a space and hit enter

Apomorphine in the treatment of Parkinson's disease.
J Neurosci Nurs 2001; 33(1):21-34, 37-8JN

Abstract

Apomorphine is a potent, nonselective, direct-acting dopamine-receptor agonist. Given subcutaneously, it has a rapid onset of antiparkinsonian action qualitatively comparable to that of levodopa. Despite its long history, it was not until peripheral dopaminergic side effects could be controlled by oral domperidone that the clinical usefulness of apomorphine in Parkinson's disease began to be investigated thoroughly in the mid-1980s. Although several routes have been tried, subcutaneous administration, either as intermittent injections or continuous infusion, is so far the best and most applied in the treatment of advanced, fluctuating Parkinson's disease. Clinical trials have shown stable efficacy with markedly reduced time spent in "off" phases as well as, for infusion therapy, reduced levodopa requirements. In the most successful cases, motor fluctuations disappear and the need for oral medication is eliminated. Adverse events are usually mild and dominated by cutaneous reactions. Neuropsychiatric side effects occur, but the influence of apomorphine on these remains controversial. Controlled long-term clinical trials are highly warranted to reveal the full potentials of this treatment. Careful patient selection and follow-up, where the specialized movement disorder nurse has a crucial role, are paramount for a successful long-term outcome. Apomorphine warrants a wider application in the treatment of advanced Parkinson's disease and should be tried before more invasive interventions are considered.

Authors+Show Affiliations

Section of Restorative Neurology, Department of Clinical Neuroscience, Division of Neurology, Wallenberg Neuroscience Center/BMC A11, University Hospital, SE-221 84, Lund, Sweden.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

11233359

Citation

Hagell, P, and P Odin. "Apomorphine in the Treatment of Parkinson's Disease." The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses, vol. 33, no. 1, 2001, pp. 21-34, 37-8.
Hagell P, Odin P. Apomorphine in the treatment of Parkinson's disease. J Neurosci Nurs. 2001;33(1):21-34, 37-8.
Hagell, P., & Odin, P. (2001). Apomorphine in the treatment of Parkinson's disease. The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses, 33(1), pp. 21-34, 37-8.
Hagell P, Odin P. Apomorphine in the Treatment of Parkinson's Disease. J Neurosci Nurs. 2001;33(1):21-34, 37-8. PubMed PMID: 11233359.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Apomorphine in the treatment of Parkinson's disease. AU - Hagell,P, AU - Odin,P, PY - 2001/3/10/pubmed PY - 2001/5/25/medline PY - 2001/3/10/entrez SP - 21-34, 37-8 JF - The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses JO - J Neurosci Nurs VL - 33 IS - 1 N2 - Apomorphine is a potent, nonselective, direct-acting dopamine-receptor agonist. Given subcutaneously, it has a rapid onset of antiparkinsonian action qualitatively comparable to that of levodopa. Despite its long history, it was not until peripheral dopaminergic side effects could be controlled by oral domperidone that the clinical usefulness of apomorphine in Parkinson's disease began to be investigated thoroughly in the mid-1980s. Although several routes have been tried, subcutaneous administration, either as intermittent injections or continuous infusion, is so far the best and most applied in the treatment of advanced, fluctuating Parkinson's disease. Clinical trials have shown stable efficacy with markedly reduced time spent in "off" phases as well as, for infusion therapy, reduced levodopa requirements. In the most successful cases, motor fluctuations disappear and the need for oral medication is eliminated. Adverse events are usually mild and dominated by cutaneous reactions. Neuropsychiatric side effects occur, but the influence of apomorphine on these remains controversial. Controlled long-term clinical trials are highly warranted to reveal the full potentials of this treatment. Careful patient selection and follow-up, where the specialized movement disorder nurse has a crucial role, are paramount for a successful long-term outcome. Apomorphine warrants a wider application in the treatment of advanced Parkinson's disease and should be tried before more invasive interventions are considered. SN - 0888-0395 UR - https://www.unboundmedicine.com/medline/citation/11233359/Apomorphine_in_the_treatment_of_Parkinson's_disease_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=11233359.ui DB - PRIME DP - Unbound Medicine ER -