Principles of drug therapy for Parkinson’s disease

Once Parkinson’s disease is clearly diagnosed, non-pharmacological treatment should be implemented immediately. Non-pharmacological treatment includes: supplementing various kinds of nutrition, actively exercising, learning and improving knowledge and general knowledge about PD, families and all walks of life should give PD patients warm care and meticulous care, establish and encourage their confidence to overcome the disease. With the gradual progress of the disease can be applied to drug therapy, commonly used drugs are the following six categories: 1, levodopa class: domestic only Medobar (dobutamine) and Xining (Cazodopa controlled release); 2, dopamine receptor agonists, common such as: Senfuro (pramipexole hydrochloride), ropinirole and Tysudar (piribedil extended release); 3, catechol-O-methyltransferase (COMT) inhibitors 4. monoamine oxidase B inhibitors, two of which are available: selangonium (propargite) and resagiline; 5. amantadine; 6. anticholinergic drugs, benzhexol hydrochloride. To date, PD requires patients to take medication for life and cannot be completely cured. Various medications and surgical treatments can only serve to delay the development of PD, and if medications are used scientifically and reasonably, most patients can control their symptoms and survive for 20-25 years, or even longer. The ideal goals of current drug therapy are: 1) to minimize the patient’s disability function; 2) to improve the patient’s quality of life; 3) to extend the patient’s life expectancy; 4) to assess the cost effectiveness (efficacy to price ratio) of drug therapy; 5) to pay attention to the physical and mental health status of the patient’s family and caregivers. When doctors prescribe anti-PD drug therapy, they must clearly explain to the patient how to take the medication and the principles of PD drug therapy, the starting dose of drug therapy should be titrated (from a small dose slowly and gradually increase), generally need 10-14 days, this period is called the drug adaptation period, during which the doctor is only concerned about the patient’s reaction after taking the drug and the occurrence of various adverse events, and do not look at drug efficacy, and then enter the drug adjustment period After that, we enter the drug adjustment period, during which the doctor adjusts the drug to the ideal dose according to the patient’s needs and tries to maintain long-term PD treatment. In general, PD drug therapy should follow the following five principles: 1, try to use the drug early to benefit as soon as possible; 2, all drugs are slowly increased by dose titration until the symptoms improve up to 80-85%, this method can avoid the occurrence of recent adverse drug reactions; 3, according to changes in the condition of the appropriate dosage: PD drug therapy is generally used to maintain a still good functional status at the minimum dose, when the condition is aggravated, the doctor should increase the dosage at the appropriate time. Doctors should increase the dosage at the right time, so as to achieve a long flow of water and not to seek full effect; 4. Individualization of medication: individualized guidance of medication according to different conditions; 5. When using various medications, the principle of continuous stimulation of dopamine energy should be maintained as much as possible.