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Update on apomorphine for the rapid treatment of hypomobility ("off") episodes in Parkinson's disease.
Pharmacotherapy. 2006 Jun; 26(6):840-52.P

Abstract

As Parkinson's disease progresses, fluctuations between akinesia, or hypomobility ("off" times), and mobility ("on" times) increase in frequency despite optimized pharmacotherapy. Motor fluctuations include predictable shortening of therapeutic effects, nocturnal or early morning akinesia, random hypomobility, and delayed mobility (variable responses to individual doses of drugs). Current oral antiparkinson drugs are inadequate for rapid and consistent relief of symptoms during hypomobility. Apomorphine, an injectable dopamine agonist recently introduced in the United States, is indicated for the management of hypomobility associated with advanced Parkinson's disease. Subcutaneous apomorphine is effective for rapid and consistent rescue from hypomobility, with a magnitude of motor improvement similar to that of levodopa. The effect begins within 20 minutes after dosing and lasts approximately 100 minutes. Therapeutic rescue doses are 2-6 mg, and patients typically require approximately three rescue doses/day. Apomorphine is associated with a clinically significant potential to cause nausea and orthostatic hypotension. These potential effects can be managed with antiemetic prophylaxis and appropriate determination of the therapeutic rescue dose.

Authors+Show Affiliations

School of Pharmacy, University of Missouri-Kansas City, and the Department of Pharmacy, Kansas City Veterans Affairs Medical Center, Kansas City, Missouri 64108, USA. oberingc@umkc.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16716137

Citation

Obering, Crystal D., et al. "Update On Apomorphine for the Rapid Treatment of Hypomobility ("off") Episodes in Parkinson's Disease." Pharmacotherapy, vol. 26, no. 6, 2006, pp. 840-52.
Obering CD, Chen JJ, Swope DM. Update on apomorphine for the rapid treatment of hypomobility ("off") episodes in Parkinson's disease. Pharmacotherapy. 2006;26(6):840-52.
Obering, C. D., Chen, J. J., & Swope, D. M. (2006). Update on apomorphine for the rapid treatment of hypomobility ("off") episodes in Parkinson's disease. Pharmacotherapy, 26(6), 840-52.
Obering CD, Chen JJ, Swope DM. Update On Apomorphine for the Rapid Treatment of Hypomobility ("off") Episodes in Parkinson's Disease. Pharmacotherapy. 2006;26(6):840-52. PubMed PMID: 16716137.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Update on apomorphine for the rapid treatment of hypomobility ("off") episodes in Parkinson's disease. AU - Obering,Crystal D, AU - Chen,Jack J, AU - Swope,David M, PY - 2006/5/24/pubmed PY - 2006/12/9/medline PY - 2006/5/24/entrez SP - 840 EP - 52 JF - Pharmacotherapy JO - Pharmacotherapy VL - 26 IS - 6 N2 - As Parkinson's disease progresses, fluctuations between akinesia, or hypomobility ("off" times), and mobility ("on" times) increase in frequency despite optimized pharmacotherapy. Motor fluctuations include predictable shortening of therapeutic effects, nocturnal or early morning akinesia, random hypomobility, and delayed mobility (variable responses to individual doses of drugs). Current oral antiparkinson drugs are inadequate for rapid and consistent relief of symptoms during hypomobility. Apomorphine, an injectable dopamine agonist recently introduced in the United States, is indicated for the management of hypomobility associated with advanced Parkinson's disease. Subcutaneous apomorphine is effective for rapid and consistent rescue from hypomobility, with a magnitude of motor improvement similar to that of levodopa. The effect begins within 20 minutes after dosing and lasts approximately 100 minutes. Therapeutic rescue doses are 2-6 mg, and patients typically require approximately three rescue doses/day. Apomorphine is associated with a clinically significant potential to cause nausea and orthostatic hypotension. These potential effects can be managed with antiemetic prophylaxis and appropriate determination of the therapeutic rescue dose. SN - 0277-0008 UR - https://www.unboundmedicine.com/medline/citation/16716137/Update_on_apomorphine_for_the_rapid_treatment_of_hypomobility__"off"__episodes_in_Parkinson's_disease_ L2 - https://doi.org/10.1592/phco.26.6.840 DB - PRIME DP - Unbound Medicine ER -