Kinetic-dynamic relationship of oral levodopa: possible biphasic response after sequential doses in Parkinson's disease.
Identifieur interne : 001459 ( Ncbi/Curation ); précédent : 001458; suivant : 001460Kinetic-dynamic relationship of oral levodopa: possible biphasic response after sequential doses in Parkinson's disease.
Auteurs : M. Contin [Italie] ; R. Riva ; P. Martinelli ; A. BaruzziSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 1992.
English descriptors
- KwdEn :
- Adult, Benserazide (administration & dosage), Benserazide (adverse effects), Benserazide (pharmacokinetics), Carbidopa (administration & dosage), Carbidopa (adverse effects), Carbidopa (pharmacokinetics), Drug Therapy, Combination, Female, Humans, Levodopa (administration & dosage), Levodopa (adverse effects), Levodopa (pharmacokinetics), Male, Middle Aged, Motor Skills (drug effects), Motor Skills (physiology), Neurologic Examination (drug effects), Parkinson Disease (blood), Parkinson Disease (drug therapy), Reaction Time (drug effects), Reaction Time (physiology).
- MESH :
- chemical , administration & dosage : Benserazide, Carbidopa, Levodopa.
- chemical , adverse effects : Benserazide, Carbidopa, Levodopa.
- chemical , pharmacokinetics : Benserazide, Carbidopa, Levodopa.
- blood : Parkinson Disease.
- drug effects : Motor Skills, Neurologic Examination, Reaction Time.
- drug therapy : Parkinson Disease.
- physiology : Motor Skills, Reaction Time.
- Adult, Drug Therapy, Combination, Female, Humans, Male, Middle Aged.
Abstract
The potential difference in the concentration-effect relationship of oral sequential doses of levodopa was explored in six Parkinsonian patients with complex fluctuating response. These patients showed "wearing-off phenomena" characterized by a transient worsening of motor function at the end of the first morning dose response to below baseline values and complained of a progressive reduction of levodopa effect during the day. A first standard levodopa dose was given in the morning, after an overnight fast and levodopa withdrawal. A second equal levodopa dose was administered immediately at the end of the first dose deterioration phase. Postimprovement worsening of motor response was also observed after the second levodopa dose in all patients. No significant difference in the pharmacokinetics of levodopa or in duration or magnitude of motor response could be appreciated between the two doses. These results further support the suggestion that, under controlled dietary conditions, plasma levodopa levels and effects relationship is reproducible between doses. Moreover, even when transient deterioration of motor function occurs between levodopa doses, the central dopaminergic system appears to remain responsive to the drug.
DOI: 10.1002/mds.870070310
PubMed: 1620142
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pubmed:1620142Le document en format XML
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<author><name sortKey="Contin, M" sort="Contin, M" uniqKey="Contin M" first="M" last="Contin">M. Contin</name>
<affiliation wicri:level="1"><nlm:affiliation>Laboratory of Neuropharmacology, University of Bologna, Italy.</nlm:affiliation>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Laboratory of Neuropharmacology, University of Bologna</wicri:regionArea>
<wicri:noRegion>University of Bologna</wicri:noRegion>
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<author><name sortKey="Riva, R" sort="Riva, R" uniqKey="Riva R" first="R" last="Riva">R. Riva</name>
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<author><name sortKey="Martinelli, P" sort="Martinelli, P" uniqKey="Martinelli P" first="P" last="Martinelli">P. Martinelli</name>
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<author><name sortKey="Baruzzi, A" sort="Baruzzi, A" uniqKey="Baruzzi A" first="A" last="Baruzzi">A. Baruzzi</name>
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<term>Benserazide (pharmacokinetics)</term>
<term>Carbidopa (administration & dosage)</term>
<term>Carbidopa (adverse effects)</term>
<term>Carbidopa (pharmacokinetics)</term>
<term>Drug Therapy, Combination</term>
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<term>Humans</term>
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<term>Levodopa (pharmacokinetics)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Motor Skills (drug effects)</term>
<term>Motor Skills (physiology)</term>
<term>Neurologic Examination (drug effects)</term>
<term>Parkinson Disease (blood)</term>
<term>Parkinson Disease (drug therapy)</term>
<term>Reaction Time (drug effects)</term>
<term>Reaction Time (physiology)</term>
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<term>Carbidopa</term>
<term>Levodopa</term>
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<term>Reaction Time</term>
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<term>Drug Therapy, Combination</term>
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<term>Humans</term>
<term>Male</term>
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<front><div type="abstract" xml:lang="en">The potential difference in the concentration-effect relationship of oral sequential doses of levodopa was explored in six Parkinsonian patients with complex fluctuating response. These patients showed "wearing-off phenomena" characterized by a transient worsening of motor function at the end of the first morning dose response to below baseline values and complained of a progressive reduction of levodopa effect during the day. A first standard levodopa dose was given in the morning, after an overnight fast and levodopa withdrawal. A second equal levodopa dose was administered immediately at the end of the first dose deterioration phase. Postimprovement worsening of motor response was also observed after the second levodopa dose in all patients. No significant difference in the pharmacokinetics of levodopa or in duration or magnitude of motor response could be appreciated between the two doses. These results further support the suggestion that, under controlled dietary conditions, plasma levodopa levels and effects relationship is reproducible between doses. Moreover, even when transient deterioration of motor function occurs between levodopa doses, the central dopaminergic system appears to remain responsive to the drug.</div>
</front>
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