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Clinical insights into use of apomorphine in Parkinson's disease: tools for clinicians.
Neurodegener Dis Manag 2014; 4(3):271-82ND

Abstract

Apomorphine was introduced before the era of levodopa as a treatment for idiopathic Parkinson's disease (iPD). A number of practical obstacles were to be solved before a wider use of the drug was possible. Today, however, the drug is probably still underutilized. Apomorphine is a strong nonergoline D1 and D2 receptor agonist with a dopaminergic effect comparable with levodopa. In this review motor and non-motor indications for intermittent injections and subcutaneous apomorphine infusions are listed. The reduction of 'off' periods is more than 50% on infusion therapy and if monotherapy is achieved a significant reduction of pre-existing levodopainduced dyskinesias is seen. The aim of this review is to give practical insight into apomorphine treatment, highlighting side effects, and complications and device-related problems are discussed with advice on how to prevent or handle these, should they occur. A number of practical points including the apomorphine test, requirements of the clinical setting, how to increase adherence and troubleshooting are added.

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  • Publisher Full Text

    • Authors

    Henriksen T
    No affiliation info available

    MeSH

    Antiparkinson AgentsApomorphineClinical Trials as TopicDrug Delivery SystemsHumansParkinson Disease

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    25095821

    Citation

    Henriksen, Tove. "Clinical Insights Into Use of Apomorphine in Parkinson's Disease: Tools for Clinicians." Neurodegenerative Disease Management, vol. 4, no. 3, 2014, pp. 271-82.
    Henriksen T. Clinical insights into use of apomorphine in Parkinson's disease: tools for clinicians. Neurodegener Dis Manag. 2014;4(3):271-82.
    Henriksen, T. (2014). Clinical insights into use of apomorphine in Parkinson's disease: tools for clinicians. Neurodegenerative Disease Management, 4(3), pp. 271-82. doi:10.2217/nmt.14.17.
    Henriksen T. Clinical Insights Into Use of Apomorphine in Parkinson's Disease: Tools for Clinicians. Neurodegener Dis Manag. 2014;4(3):271-82. PubMed PMID: 25095821.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Clinical insights into use of apomorphine in Parkinson's disease: tools for clinicians. A1 - Henriksen,Tove, PY - 2014/8/7/entrez PY - 2014/8/7/pubmed PY - 2015/3/31/medline KW - apomorphine infusion KW - apomorphine injection KW - apomorphine test KW - dystonia KW - hyperkinesias KW - impulse control disorder KW - motor fluctuations KW - motor symptoms KW - non-motor symptoms KW - rescue medication SP - 271 EP - 82 JF - Neurodegenerative disease management JO - Neurodegener Dis Manag VL - 4 IS - 3 N2 - Apomorphine was introduced before the era of levodopa as a treatment for idiopathic Parkinson's disease (iPD). A number of practical obstacles were to be solved before a wider use of the drug was possible. Today, however, the drug is probably still underutilized. Apomorphine is a strong nonergoline D1 and D2 receptor agonist with a dopaminergic effect comparable with levodopa. In this review motor and non-motor indications for intermittent injections and subcutaneous apomorphine infusions are listed. The reduction of 'off' periods is more than 50% on infusion therapy and if monotherapy is achieved a significant reduction of pre-existing levodopainduced dyskinesias is seen. The aim of this review is to give practical insight into apomorphine treatment, highlighting side effects, and complications and device-related problems are discussed with advice on how to prevent or handle these, should they occur. A number of practical points including the apomorphine test, requirements of the clinical setting, how to increase adherence and troubleshooting are added. SN - 1758-2032 UR - https://www.unboundmedicine.com/medline/citation/25095821/Clinical_insights_into_use_of_apomorphine_in_Parkinson's_disease:_tools_for_clinicians_ L2 - http://www.futuremedicine.com/doi/full/10.2217/nmt.14.17?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -