Apomorphine infusional therapy in Parkinson's disease: clinical utility and lack of tolerance.
Apomorphine infusional therapy in Parkinson's disease: clinical utility and lack of tolerance.
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阿扑吗啡输注治疗帕金森病：临床实用性和缺乏耐受性。
DOI：
10.1002/mds.870100108
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Woodward,WR
中科院分区：
文献类型：
--
作者：
Gancher,ST;Nutt,JG;Woodward,WR
我们评估了阿扑吗啡输注治疗帕金森综合征和运动波动患者的临床效用，并寻找长期治疗导致药物反应改变的证据。本文报告6例帕金森病患者，用S. C.在清醒时间注射阿扑吗啡。在研究开始和结束时，给予试验剂量的阿扑吗啡（12.5-100 μg/kg）以建立剂量反应曲线。在这项研究中，患者报告说，他们每天的“开”时间有了显著的改善，并大大减少了左旋多巴和其他抗帕金森病药物的剂量和频率。研究期间未观察到阿扑吗啡剂量-反应关系或药代动力学的平均变化。然而，两名患者在3个月的观察期间降低了输注速率，并在研究结束时给予阿扑吗啡试验剂量后表现出更高的药物水平和更长的反应。尽管对使用输液泵溶液和不良反应的实际关注限制了治疗提供的总体益处，但这种药物治疗可能对某些患有严重帕金森综合征和波动的患者有用。
We assessed the clinical utility of apomorphine infusional therapy in patients with parkinsonism and motor fluctuations and sought evidence for alterations in drug response resulting from chronic treatment. Six patients with Parkinson's disease were treated for 3 months with s. c. infusions of apomorphine administered during waking hours. At the beginning and the end of the study, test doses of apomorphine (12.5–100 μg/kg) were administered to establish a dose‐response curve. Over the study, the patients reported a significant improvement in the number of “on” hours experienced per day and substantially reduced the dose and frequency of levodopa and other antiparkinsonian medications. No average change in apomorphine dose‐response relationships or pharmacokinetics was observed during the study. However, two patients lowered the infusion rate during the 3‐month observation and exhibited higher drug levels and longer responses following test doses of apomorphine given at the end of the study. Although pragmatic concerns with the use of infusion pumps solutions and adverse effects limited the overall benefit afforded by the treatment, this kind of drug treatment may be useful in selected patients with severe parkinsonism and fluctuations.