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b. NEWER DRUGS
1. Cathechol o-methyltranferase (COM) inhibitor
1.1. Entacapone (Contan)-used in combination of
levadopa and carbidopa.
1.2 Stavelo – a combination of levodopa,cabidopa and
entacapone.
1.3 Tolcapone (Tasmar)
2. Monoamine oxidase (MAO) inhibitors
Selegiline(Eldepryl) - may be prescribed to confer mild
symptomatic benefit
before initiating dopaminergics in the treatment of PD.
Ex. Carbex, Eldepryl, Novo-Selegiline
- reduce metabolic breakdown of dopamine
c. INVESTIGATIONAL DRUGS
1. Coenzyme Q10 – may slow the rate of functional
declines
2. Dextromethorphan glial – derived neurotrophic factor
--- administered directly into the brain.
B. Surgical Treatment
• Lesion surgery (burning of tissue)
• Deep brain stimulation (DBS)
• Neural grafting or tissue transplants
• Pallidotomy and thalamotomy are rarely done
anymore. They involve the precise destruction of very
small areas in the deep part of the brain that cause
symptoms.
• Neurotransplantation surgery
• Fetal Tissue Transplantation is an experimental
and highly controversial procedure. Fetal substantia
nigra tissue either human or pig is transplanted into
the caudate nucleus of the brain.
1. Impaired Physical Mobility related to
neuromuscular impairment
a. Daily exercise increases muscle strength,
improve coordination and dexterity,
reduce muscular rigidity and prevent
contractures.
b. Stretching and ROM exercise to promote
joint flexibility.
c. Postural exercises are important to counter
the tendency of the head and neck to be
drawn forward and down.
d. Warm baths and massage help relax the
muscle and relieve painful muscle spasms
that accompany rigidity.
2. Self- Care Deficit related to
tremor and motor disturbance