Sublingual apomorphine: a new pharmacological approach in Parkinson's disease?
Identifieur interne : 001472 ( PubMed/Checkpoint ); précédent : 001471; suivant : 001473Sublingual apomorphine: a new pharmacological approach in Parkinson's disease?
Auteurs : J L Montastruc [France] ; O. Rascol ; J M Senard ; G. Houin ; A. RascolSource :
- Journal of neural transmission. Supplementum [ 0303-6995 ] ; 1995.
English descriptors
- KwdEn :
- Administration, Sublingual, Antiparkinson Agents (adverse effects), Antiparkinson Agents (pharmacokinetics), Apomorphine (administration & dosage), Apomorphine (adverse effects), Apomorphine (pharmacokinetics), Dopamine Agonists (administration & dosage), Dopamine Agonists (adverse effects), Dopamine Agonists (pharmacokinetics), Humans, Parkinson Disease (drug therapy), Parkinson Disease (metabolism), Pilot Projects.
- MESH :
- chemical , administration & dosage : Apomorphine, Dopamine Agonists.
- chemical , adverse effects : Antiparkinson Agents, Apomorphine, Dopamine Agonists.
- chemical , pharmacokinetics : Antiparkinson Agents, Apomorphine, Dopamine Agonists.
- drug therapy : Parkinson Disease.
- metabolism : Parkinson Disease.
- Administration, Sublingual, Humans, Pilot Projects.
Abstract
Apomorphine, a potent dopamine agonist with mixed D1 and D2 properties, has long been recognized to have antiparkinsonian effect. Its oral administration is limited by both its hepatic first pass metabolism and adverse side effects (nausea, vomiting, azotemia). It is now widely used by subcutaneous route for the treatment of severe "off" periods seen with levodopa treatment. However, the use of penjects can be difficult in some patients with severe tremor or akineto-rigid symptoms during "off" periods. Our group has recently investigated the effect of sublingual administration of apomorphine in patients suffering from Parkinson's disease. Sublingual apomorphine was shown to reduce extrapyramidal symptoms. The main characteristics of the pharmacodynamic effects of sublingual apomorphine in parkinsonians and the relationship between pharmacodynamic and pharmacokinetic effects are discussed. Sublingual apomorphine has the advantage of being easier to administer than subcutaneous injection. For the moment, the long-term use of sublingual apomorphine is limited by two major problems: first, time for dissolution and switch "on" (which is longer than after subcutaneous route) and secondly, the occurrence of local side effects (stomatitis). Further clinical studies using either more efficient (tablets with faster dissolution) and better tolerated sublingual formulations or other dopamine agonists should be carried on before recommending this approach in the treatment of Parkinson's disease.
PubMed: 8748621
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Sublingual apomorphine: a new pharmacological approach in Parkinson's disease?</title><author><name sortKey="Montastruc, J L" sort="Montastruc, J L" uniqKey="Montastruc J" first="J L" last="Montastruc">J L Montastruc</name><affiliation wicri:level="3"><nlm:affiliation>Laboratoire de Pharmacologie Médicale et Clinique, INSERM U317, Faculté de Médecine, Toulouse, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Laboratoire de Pharmacologie Médicale et Clinique, INSERM U317, Faculté de Médecine, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Rascol, O" sort="Rascol, O" uniqKey="Rascol O" first="O" last="Rascol">O. Rascol</name></author><author><name sortKey="Senard, J M" sort="Senard, J M" uniqKey="Senard J" first="J M" last="Senard">J M Senard</name></author><author><name sortKey="Houin, G" sort="Houin, G" uniqKey="Houin G" first="G" last="Houin">G. Houin</name></author><author><name sortKey="Rascol, A" sort="Rascol, A" uniqKey="Rascol A" first="A" last="Rascol">A. Rascol</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1995">1995</date><idno type="RBID">pubmed:8748621</idno><idno type="pmid">8748621</idno><idno type="wicri:Area/PubMed/Corpus">001649</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001649</idno><idno type="wicri:Area/PubMed/Curation">001608</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001608</idno><idno type="wicri:Area/PubMed/Checkpoint">001608</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">001608</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Sublingual apomorphine: a new pharmacological approach in Parkinson's disease?</title><author><name sortKey="Montastruc, J L" sort="Montastruc, J L" uniqKey="Montastruc J" first="J L" last="Montastruc">J L Montastruc</name><affiliation wicri:level="3"><nlm:affiliation>Laboratoire de Pharmacologie Médicale et Clinique, INSERM U317, Faculté de Médecine, Toulouse, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Laboratoire de Pharmacologie Médicale et Clinique, INSERM U317, Faculté de Médecine, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Rascol, O" sort="Rascol, O" uniqKey="Rascol O" first="O" last="Rascol">O. Rascol</name></author><author><name sortKey="Senard, J M" sort="Senard, J M" uniqKey="Senard J" first="J M" last="Senard">J M Senard</name></author><author><name sortKey="Houin, G" sort="Houin, G" uniqKey="Houin G" first="G" last="Houin">G. Houin</name></author><author><name sortKey="Rascol, A" sort="Rascol, A" uniqKey="Rascol A" first="A" last="Rascol">A. Rascol</name></author></analytic><series><title level="j">Journal of neural transmission. Supplementum</title><idno type="ISSN">0303-6995</idno><imprint><date when="1995" type="published">1995</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Administration, Sublingual</term><term>Antiparkinson Agents (adverse effects)</term><term>Antiparkinson Agents (pharmacokinetics)</term><term>Apomorphine (administration & dosage)</term><term>Apomorphine (adverse effects)</term><term>Apomorphine (pharmacokinetics)</term><term>Dopamine Agonists (administration & dosage)</term><term>Dopamine Agonists (adverse effects)</term><term>Dopamine Agonists (pharmacokinetics)</term><term>Humans</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (metabolism)</term><term>Pilot Projects</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Apomorphine</term><term>Dopamine Agonists</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiparkinson Agents</term><term>Apomorphine</term><term>Dopamine Agonists</term></keywords><keywords scheme="MESH" type="chemical" qualifier="pharmacokinetics" xml:lang="en"><term>Antiparkinson Agents</term><term>Apomorphine</term><term>Dopamine Agonists</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="metabolism" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Administration, Sublingual</term><term>Humans</term><term>Pilot Projects</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Apomorphine, a potent dopamine agonist with mixed D1 and D2 properties, has long been recognized to have antiparkinsonian effect. Its oral administration is limited by both its hepatic first pass metabolism and adverse side effects (nausea, vomiting, azotemia). It is now widely used by subcutaneous route for the treatment of severe "off" periods seen with levodopa treatment. However, the use of penjects can be difficult in some patients with severe tremor or akineto-rigid symptoms during "off" periods. Our group has recently investigated the effect of sublingual administration of apomorphine in patients suffering from Parkinson's disease. Sublingual apomorphine was shown to reduce extrapyramidal symptoms. The main characteristics of the pharmacodynamic effects of sublingual apomorphine in parkinsonians and the relationship between pharmacodynamic and pharmacokinetic effects are discussed. Sublingual apomorphine has the advantage of being easier to administer than subcutaneous injection. For the moment, the long-term use of sublingual apomorphine is limited by two major problems: first, time for dissolution and switch "on" (which is longer than after subcutaneous route) and secondly, the occurrence of local side effects (stomatitis). Further clinical studies using either more efficient (tablets with faster dissolution) and better tolerated sublingual formulations or other dopamine agonists should be carried on before recommending this approach in the treatment of Parkinson's disease.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">8748621</PMID><DateCreated><Year>1996</Year><Month>10</Month><Day>23</Day></DateCreated><DateCompleted><Year>1996</Year><Month>10</Month><Day>23</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0303-6995</ISSN><JournalIssue CitedMedium="Print"><Volume>45</Volume><PubDate><Year>1995</Year></PubDate></JournalIssue><Title>Journal of neural transmission. Supplementum</Title><ISOAbbreviation>J. Neural Transm. Suppl.</ISOAbbreviation></Journal><ArticleTitle>Sublingual apomorphine: a new pharmacological approach in Parkinson's disease?</ArticleTitle><Pagination><MedlinePgn>157-61</MedlinePgn></Pagination><Abstract><AbstractText>Apomorphine, a potent dopamine agonist with mixed D1 and D2 properties, has long been recognized to have antiparkinsonian effect. Its oral administration is limited by both its hepatic first pass metabolism and adverse side effects (nausea, vomiting, azotemia). It is now widely used by subcutaneous route for the treatment of severe "off" periods seen with levodopa treatment. However, the use of penjects can be difficult in some patients with severe tremor or akineto-rigid symptoms during "off" periods. Our group has recently investigated the effect of sublingual administration of apomorphine in patients suffering from Parkinson's disease. Sublingual apomorphine was shown to reduce extrapyramidal symptoms. The main characteristics of the pharmacodynamic effects of sublingual apomorphine in parkinsonians and the relationship between pharmacodynamic and pharmacokinetic effects are discussed. Sublingual apomorphine has the advantage of being easier to administer than subcutaneous injection. For the moment, the long-term use of sublingual apomorphine is limited by two major problems: first, time for dissolution and switch "on" (which is longer than after subcutaneous route) and secondly, the occurrence of local side effects (stomatitis). Further clinical studies using either more efficient (tablets with faster dissolution) and better tolerated sublingual formulations or other dopamine agonists should be carried on before recommending this approach in the treatment of Parkinson's disease.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Montastruc</LastName><ForeName>J L</ForeName><Initials>JL</Initials><AffiliationInfo><Affiliation>Laboratoire de Pharmacologie Médicale et Clinique, INSERM U317, Faculté de Médecine, Toulouse, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rascol</LastName><ForeName>O</ForeName><Initials>O</Initials></Author><Author ValidYN="Y"><LastName>Senard</LastName><ForeName>J M</ForeName><Initials>JM</Initials></Author><Author ValidYN="Y"><LastName>Houin</LastName><ForeName>G</ForeName><Initials>G</Initials></Author><Author ValidYN="Y"><LastName>Rascol</LastName><ForeName>A</ForeName><Initials>A</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>Austria</Country><MedlineTA>J Neural Transm Suppl</MedlineTA><NlmUniqueID>0425126</NlmUniqueID><ISSNLinking>0303-6995</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000978">Antiparkinson Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D018491">Dopamine Agonists</NameOfSubstance></Chemical><Chemical><RegistryNumber>N21FAR7B4S</RegistryNumber><NameOfSubstance UI="D001058">Apomorphine</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000286" MajorTopicYN="N">Administration, Sublingual</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000978" MajorTopicYN="N">Antiparkinson Agents</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName><QualifierName UI="Q000493" MajorTopicYN="N">pharmacokinetics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001058" MajorTopicYN="N">Apomorphine</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000493" MajorTopicYN="N">pharmacokinetics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018491" MajorTopicYN="N">Dopamine Agonists</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000493" MajorTopicYN="N">pharmacokinetics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010300" MajorTopicYN="N">Parkinson Disease</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010865" MajorTopicYN="N">Pilot Projects</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1995</Year><Month>1</Month><Day>1</Day></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>1995</Year><Month>1</Month><Day>1</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>1995</Year><Month>1</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">8748621</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>France</li></country><region><li>Midi-Pyrénées</li><li>Occitanie (région administrative)</li></region><settlement><li>Toulouse</li></settlement></list><tree><noCountry><name sortKey="Houin, G" sort="Houin, G" uniqKey="Houin G" first="G" last="Houin">G. Houin</name><name sortKey="Rascol, A" sort="Rascol, A" uniqKey="Rascol A" first="A" last="Rascol">A. Rascol</name><name sortKey="Rascol, O" sort="Rascol, O" uniqKey="Rascol O" first="O" last="Rascol">O. Rascol</name><name sortKey="Senard, J M" sort="Senard, J M" uniqKey="Senard J" first="J M" last="Senard">J M Senard</name></noCountry><country name="France"><region name="Occitanie (région administrative)"><name sortKey="Montastruc, J L" sort="Montastruc, J L" uniqKey="Montastruc J" first="J L" last="Montastruc">J L Montastruc</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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