Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
CLINICAL USEFULNESS OF APOMORPHINE IN MOVEMENT-DISORDERS
Autore:
COLOSIMO C; MERELLO M; ALBANESE A;
Indirizzi:
CATHOLIC UNIV SACRED HEART,INST NEUROL,LARGO A GEMELLI 8 I-00168 ROMEITALY FLENI BUENOS AIRES ARGENTINA
Titolo Testata:
Clinical neuropharmacology
fascicolo: 3, volume: 17, anno: 1994,
pagine: 243 - 259
SICI:
0362-5664(1994)17:3<243:CUOAIM>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
ON-OFF FLUCTUATIONS; SUBCUTANEOUS LISURIDE INFUSION; UNTREATED PARKINSONS-DISEASE; L-DOPA; DOPAMINERGIC RESPONSIVENESS; INTRANASAL APOMORPHINE; MOTOR FLUCTUATIONS; SUBLINGUAL APOMORPHINE; HUNTINGTONS-CHOREA; MALIGNANT SYNDROME;
Keywords:
APOMORPHINE; DOPAMINE; DYSTONIA; HUNTINGTONS DISEASE; LEVODOPA; LISURIDE; PARKINSONS DISEASE;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
84
Recensione:
Indirizzi per estratti:
Citazione:
C. Colosimo et al., "CLINICAL USEFULNESS OF APOMORPHINE IN MOVEMENT-DISORDERS", Clinical neuropharmacology, 17(3), 1994, pp. 243-259

Abstract

Apomorphine, the first dopamine agonist to be synthesized, has received a renewed interest in the last few years. This compound acts powerfully on D-1 and D-2 dopamine receptors and has the most complete pharmacological profile of all clinically available dopamine agonists. Whengiven subcutaneously, apomorphine consistently reverses levodopa-resistant ''off'' periods in parkinsonian subjects: thus, it is used in cases with severe motor fluctuations, either by continuous infusion witha portable pump or by multiple injections. Studies based on this approach have been highly encouraging, as they have shown a significant reduction in off time and a good drug tolerability. The main side effecthas been the occurrence of nodular skin lesions, especially when continuous infusions were used. At variance with other dopamine agonists, a low incidence of psychiatric morbidity has been reported with apomorphine. The few available comparative reports have shown that this compound is more potent and better tolerated than lisuride. Parenteral apomorphine has been used in Parkinson's disease (PD) to replace levodopaafter surgery or to treat the malignant syndrome brought about by sudden levodopa withdrawal. Acute challenge with apomorphine has been used to test dopaminergic responsiveness in parkinsonian syndromes and indystonia. The clinical response to apomorphine may predict the effectof a chronic therapy with levodopa in similar to 90% of PD cases. Further studies are still necessary to evaluate the exact relationship between the acute response to apomorphine and a chronic therapy. In addition, apomorphine has been used to conduct clinical pharmacological studies in PD, for it is particularly well suited for research on the pharmacodynamics of central dopamine receptors. In summary, apomorphine appears to be an efficacious and safe drug for the treatment of advanced PD. It must still be considered under clinical evaluation as a testdrug for acute challenge in PD and dystonia. Finally, in our opinion,the available data suggest apomorphine (in conjunction with domperidone) as a first-choice treatment for the neuroleptic malignant syndromeand the temporary replacement of levodopa (e.g., after gastrointestinal surgery).

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 19:59:44