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.
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 - https://www.futuremedicine.com/doi/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 -