Intravenous boluses and continuous infusions of L‐DOPA methyl ester in fluctuating patients with Parkinson's disease
Identifieur interne : 006006 ( Main/Exploration ); précédent : 006005; suivant : 006007Intravenous boluses and continuous infusions of L‐DOPA methyl ester in fluctuating patients with Parkinson's disease
Auteurs : Stocchi [Italie] ; S. Ruggieri [Italie] ; A. Carta [Italie] ; J. Ryatt [Royaume-Uni] ; N. Quinn [Royaume-Uni] ; P. Jenner [Royaume-Uni] ; C. D. Marsden [Royaume-Uni] ; A. Agnoli [Italie]Source :
- Movement Disorders [ 0885-3185 ] ; 1992.
English descriptors
- KwdEn :
- Aged, Double-Blind Method, Drug Administration Schedule, Female, Humans, Infusions, Intravenous, Intravenous administration, Levodopa (administration & dosage), Levodopa (adverse effects), Levodopa (analogs & derivatives), Levodopa (pharmacokinetics), L‐DOPA, L‐DOPA methyl ester, Male, Middle Aged, Motor Skills (drug effects), Neurologic Examination (drug effects), Parkinson Disease (blood), Parkinson Disease (drug therapy), Parkinson's disease, Plasma levels, “On‐off” fouctuations.
- MESH :
- chemical , administration & dosage : Levodopa.
- chemical , adverse effects : Levodopa.
- chemical , analogs & derivatives : Levodopa.
- chemical , pharmacokinetics : Levodopa.
- blood : Parkinson Disease.
- drug effects : Motor Skills, Neurologic Examination.
- drug therapy : Parkinson Disease.
- Aged, Double-Blind Method, Drug Administration Schedule, Female, Humans, Infusions, Intravenous, Male, Middle Aged.
Abstract
In six patients with Parkinson's disease exhibiting severe “on‐off” phenomena, a 200‐mg intravenous bolus of either L‐DOPA or of its methyl ester were equally effective in reversing motor deficits, although the duration of action of the methyl ester was shorter. There were no marked differences in phermacokinetic parameters for L‐DOPA plasma levels after administration of L‐DOPA and the methyl ester. In three patients, optimal infusion rates for the maintenance of mobility were established for L‐DOPA and L‐DOPA methyl ester. Both drugs were able to maintain patients “on” throughout a 12‐h infusion period. However, on average the optimal infusion rate of L‐DOPA methyl ester was 2.7 times greater than that for L‐DOPA. There was no marked difference in the plasma levels of L‐DOPA achieved, but 3‐O‐methyl DOPA levels increased more after infusion of L‐DOPA methyl ester than after infusion of L‐DOPA itself. The half‐life of elimination and volume of distribution of L‐DOPA formed form the methyl ester were markedly increased compared with values obtained after either an intravenous bolus of methyl ester or after an intravenous infusion of L‐DOPA itself. An intravenous bolus of L‐DOPA methyl ester produces an equivalent magnitude of clinical response to the same dose of L‐DOPA. However, higher optimal infusion rates of methyl ester than L‐DOPA are required to produce continuous effect. The pharmacokinetic handling of L‐DOPA methyl ester given by intravenous infusion may differ from that of L‐DOPA when given by the same route.
Url:
DOI: 10.1002/mds.870070311
Affiliations:
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Ryatt</name><affiliation wicri:level="2"><country>Royaume-Uni</country><placeName><region type="country">Angleterre</region></placeName><wicri:cityArea>University Department of Clinical Neurology, Institute of Neurology, National Hospital for Nervous Diseases, King's College London, London</wicri:cityArea></affiliation></author><author><name sortKey="Quinn, N" sort="Quinn, N" uniqKey="Quinn N" first="N." last="Quinn">N. Quinn</name><affiliation wicri:level="2"><country>Royaume-Uni</country><placeName><region type="country">Angleterre</region></placeName><wicri:cityArea>Parkinson's Disease Society Experimental Research Laboratories, Pharmacology Group, Biomedical Sciences Division, King's College London</wicri:cityArea></affiliation></author><author><name sortKey="Jenner, P" sort="Jenner, P" uniqKey="Jenner P" first="P." last="Jenner">P. Jenner</name><affiliation wicri:level="2"><country>Royaume-Uni</country><placeName><region type="country">Angleterre</region></placeName><wicri:cityArea>University Department of Clinical Neurology, Institute of Neurology, National Hospital for Nervous Diseases, King's College London, London</wicri:cityArea></affiliation></author><author><name sortKey="Marsden, C D" sort="Marsden, C D" uniqKey="Marsden C" first="C. D." last="Marsden">C. D. Marsden</name><affiliation wicri:level="2"><country>Royaume-Uni</country><placeName><region type="country">Angleterre</region></placeName><wicri:cityArea>Parkinson's Disease Society Experimental Research Laboratories, Pharmacology Group, Biomedical Sciences Division, King's College London</wicri:cityArea></affiliation></author><author><name sortKey="Agnoli, A" sort="Agnoli, A" uniqKey="Agnoli A" first="A." last="Agnoli">A. 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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="1992">1992</date><biblScope unit="vol">7</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="249">249</biblScope><biblScope unit="page" to="256">256</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">15007F5F3D407182AD2F8E3D198619CD51716DE0</idno><idno type="DOI">10.1002/mds.870070311</idno><idno type="ArticleID">MDS870070311</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Double-Blind Method</term><term>Drug Administration Schedule</term><term>Female</term><term>Humans</term><term>Infusions, Intravenous</term><term>Intravenous administration</term><term>Levodopa (administration & dosage)</term><term>Levodopa (adverse effects)</term><term>Levodopa (analogs & derivatives)</term><term>Levodopa (pharmacokinetics)</term><term>L‐DOPA</term><term>L‐DOPA methyl ester</term><term>Male</term><term>Middle Aged</term><term>Motor Skills (drug effects)</term><term>Neurologic Examination (drug effects)</term><term>Parkinson Disease (blood)</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson's disease</term><term>Plasma levels</term><term>“On‐off” fouctuations</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Levodopa</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Levodopa</term></keywords><keywords scheme="MESH" type="chemical" qualifier="analogs & derivatives" xml:lang="en"><term>Levodopa</term></keywords><keywords scheme="MESH" type="chemical" qualifier="pharmacokinetics" xml:lang="en"><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Motor Skills</term><term>Neurologic Examination</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Double-Blind Method</term><term>Drug Administration Schedule</term><term>Female</term><term>Humans</term><term>Infusions, Intravenous</term><term>Male</term><term>Middle Aged</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In six patients with Parkinson's disease exhibiting severe “on‐off” phenomena, a 200‐mg intravenous bolus of either L‐DOPA or of its methyl ester were equally effective in reversing motor deficits, although the duration of action of the methyl ester was shorter. There were no marked differences in phermacokinetic parameters for L‐DOPA plasma levels after administration of L‐DOPA and the methyl ester. In three patients, optimal infusion rates for the maintenance of mobility were established for L‐DOPA and L‐DOPA methyl ester. Both drugs were able to maintain patients “on” throughout a 12‐h infusion period. However, on average the optimal infusion rate of L‐DOPA methyl ester was 2.7 times greater than that for L‐DOPA. There was no marked difference in the plasma levels of L‐DOPA achieved, but 3‐O‐methyl DOPA levels increased more after infusion of L‐DOPA methyl ester than after infusion of L‐DOPA itself. The half‐life of elimination and volume of distribution of L‐DOPA formed form the methyl ester were markedly increased compared with values obtained after either an intravenous bolus of methyl ester or after an intravenous infusion of L‐DOPA itself. An intravenous bolus of L‐DOPA methyl ester produces an equivalent magnitude of clinical response to the same dose of L‐DOPA. However, higher optimal infusion rates of methyl ester than L‐DOPA are required to produce continuous effect. The pharmacokinetic handling of L‐DOPA methyl ester given by intravenous infusion may differ from that of L‐DOPA when given by the same route.</div></front></TEI><affiliations><list><country><li>Italie</li><li>Royaume-Uni</li></country><region><li>Angleterre</li></region></list><tree><country name="Italie"><noRegion><name sortKey="Stocchi" sort="Stocchi" uniqKey="Stocchi" last="Stocchi">Stocchi</name></noRegion><name sortKey="Agnoli, A" sort="Agnoli, A" uniqKey="Agnoli A" first="A." last="Agnoli">A. Agnoli</name><name sortKey="Carta, A" sort="Carta, A" uniqKey="Carta A" first="A." last="Carta">A. Carta</name><name sortKey="Ruggieri, S" sort="Ruggieri, S" uniqKey="Ruggieri S" first="S." last="Ruggieri">S. Ruggieri</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Ryatt, J" sort="Ryatt, J" uniqKey="Ryatt J" first="J." last="Ryatt">J. Ryatt</name></region><name sortKey="Jenner, P" sort="Jenner, P" uniqKey="Jenner P" first="P." last="Jenner">P. Jenner</name><name sortKey="Marsden, C D" sort="Marsden, C D" uniqKey="Marsden C" first="C. D." last="Marsden">C. D. Marsden</name><name sortKey="Quinn, N" sort="Quinn, N" uniqKey="Quinn N" first="N." last="Quinn">N. Quinn</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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