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Intranasal apomorphine rescue therapy for parkinsonian "off" periods.
Clin Neuropharmacol. 1996 Jun; 19(3):193-201.CN

Abstract

Eleven patients with levodopa-related motor fluctuations were scored before and after intranasal apomorphine monotherapy, and the motor responses were compared with those with levodopa/carbidopa in this openlabel study. Oral trimethobenzamide was used to prevent apomorphine-induced nausea. Three measures of motor performance were employed: (a) the Unified Parkinson's Disease Rating Scale (UPDRS) motor battery; (b) a timed hand-tapping test; and (c) the Webster's step-seconds test. The magnitude of the motor-score improvement after apomorphine administration was very similar to that after the usual doses of levodopa/carbidopa in the 10 patients completing the study; this was true for all three outcome measures. A major advantage of apomorphine was the rapid onset of clinical response, which typically occurred in < 10 min, as well as the ease of administration. Major side effects, beyond those experienced with levodopa/carbidopa, were limited to nausea and vomiting (three patients) and orthostatic hypotension (one patient); however, only a single patient dropped out of the study as a consequence. These results indicate that intranasal apomorphine is effective in rapidly relieving parkinsonian "off" states and that, for most patients, trimethobenzamide is an effective and well-tolerated antiemetic for use with apomorphine.

Authors+Show Affiliations

Department of Neurology, University of Texas Southwestern Medical School, Dallas 75235-8897, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8726538

Citation

Dewey, R B., et al. "Intranasal Apomorphine Rescue Therapy for Parkinsonian "off" Periods." Clinical Neuropharmacology, vol. 19, no. 3, 1996, pp. 193-201.
Dewey RB, Maraganore DM, Ahlskog JE, et al. Intranasal apomorphine rescue therapy for parkinsonian "off" periods. Clin Neuropharmacol. 1996;19(3):193-201.
Dewey, R. B., Maraganore, D. M., Ahlskog, J. E., & Matsumoto, J. Y. (1996). Intranasal apomorphine rescue therapy for parkinsonian "off" periods. Clinical Neuropharmacology, 19(3), 193-201.
Dewey RB, et al. Intranasal Apomorphine Rescue Therapy for Parkinsonian "off" Periods. Clin Neuropharmacol. 1996;19(3):193-201. PubMed PMID: 8726538.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intranasal apomorphine rescue therapy for parkinsonian "off" periods. AU - Dewey,R B,Jr AU - Maraganore,D M, AU - Ahlskog,J E, AU - Matsumoto,J Y, PY - 1996/6/1/pubmed PY - 2001/3/28/medline PY - 1996/6/1/entrez SP - 193 EP - 201 JF - Clinical neuropharmacology JO - Clin Neuropharmacol VL - 19 IS - 3 N2 - Eleven patients with levodopa-related motor fluctuations were scored before and after intranasal apomorphine monotherapy, and the motor responses were compared with those with levodopa/carbidopa in this openlabel study. Oral trimethobenzamide was used to prevent apomorphine-induced nausea. Three measures of motor performance were employed: (a) the Unified Parkinson's Disease Rating Scale (UPDRS) motor battery; (b) a timed hand-tapping test; and (c) the Webster's step-seconds test. The magnitude of the motor-score improvement after apomorphine administration was very similar to that after the usual doses of levodopa/carbidopa in the 10 patients completing the study; this was true for all three outcome measures. A major advantage of apomorphine was the rapid onset of clinical response, which typically occurred in < 10 min, as well as the ease of administration. Major side effects, beyond those experienced with levodopa/carbidopa, were limited to nausea and vomiting (three patients) and orthostatic hypotension (one patient); however, only a single patient dropped out of the study as a consequence. These results indicate that intranasal apomorphine is effective in rapidly relieving parkinsonian "off" states and that, for most patients, trimethobenzamide is an effective and well-tolerated antiemetic for use with apomorphine. SN - 0362-5664 UR - https://www.unboundmedicine.com/medline/citation/8726538/Intranasal_apomorphine_rescue_therapy_for_parkinsonian_"off"_periods_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=8726538.ui DB - PRIME DP - Unbound Medicine ER -