Prospects for successful treatment of Parkinson’s disease with the use of apomorphine

Authors

  • I.M. Karaban State Institution “D.F. Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • N.V. Karasevych State Institution “D.F. Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • T.V. Hasiuk State Institution “D.F. Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine

DOI:

https://doi.org/10.22141/2224-0713.17.4.2021.237604

Keywords:

Parkinson’s disease, apomorphine, pharmacokinetics, mechanism of action, clinical trials, indications and contraindications

Abstract

Optimizing the treatment of idiopathic Parkinson’s disease is a complex, multifaceted and continuous process that directly affects quality of life. The main position of this review is the need for individualized therapy that provides optimal motor function with the least negative consequences. Apomorphine, a dopamine agonist used as emergency therapy for patients with motor fluctuations with a potential positive effect on non-motor symptoms, is the only antiparkinsonian drug whose ability to control motor symptoms is equivalent to that of levodopa. Subcutaneous administration as a periodic injection is the most effective and affordable way to correct dopaminergic insufficiency in Parkinson’s disease. The data of multicenter studies presented in the review confirm the high efficiency, adequate tolerability and prospects of apomorphine use in comprehensive pathogenetic therapy of the disease. This review contains the historical reference and generalizes structure, the mechanism of action, pharmacodyna-mics, indications, contraindications and side effects in subcutaneous injections of apomorphine at the advanced stages of a clinical course of Parkinson’s disease.

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References

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Апоморфін у лікуванні хвороби Паркінсона

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Коли потрібно припиняти або замінювати терапію апо-морфіном?

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Показання для використання апоморфіну

Hughes A.J., Lees A.J., Stern G.M. The motor response to sequential apomorphine in parkinsonian fluctuations. J. Neurol. Neurosurg. Psychiatry. 1991. 54. 358-360. https://doi.org/10.1136/jnnp.54.4.358.

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Шляхи введення апоморфіну

Frankel J.P., Lees A.J., Kempster P.A., Stern G.M. Subcutaneous apomorphine in the treatment of Parkinson’s disease. J. Neurol. Neurosurg. Psychiatry. 1990 Feb. 53(2). 96-101. https://doi.org/10.1136/jnnp.53.2.96.

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Henriksen T. Clinical insights into use of apomorphine in Parkinson’s disease: tools for clinicians. Neurodegener. Dis. Manag. 2014. 4(3). 271-82. https://doi.org/10.2217/nmt.14.17.

Hughes A.J., Bishop S., Lees A.J., Stern G.M., Webster R., Bovingdon M. Rectal apomorphine in Parkinson’s disease. Lancet. 1991 Jan. 337(8733). 118. https://doi.org/10.1016/0140-6736(91)90780-S.

Kleedorfer B, Turjanski N, Ryan R, Lees AJ, Milroy C, Stern GM. Intranasal apomorphine in Parkinson’s disease. Neurology. 1991 May. 41(5). 761-2. https://doi.org/10.1212/WNL.41.5.761-a.

Hughes A.J., Webster R., Bovingdon M., Lees A.J., Stern G.M. Sublingual apomorphine in the treatment of Parkinson’s disease complicated by motor fluctuations. Clin. Neuropharmacol. 1991 Dec. 14(6). 556-61. https://doi.org/10.1097/00002826-199112000-00008.

Manson A.J., Hanagasi H., Turner K., Patsalos P.N., Ca-rey P., Ratnaraj N. et al. Intravenous apomorphine therapy in Parkinson’s disease: clinical and pharmacokinetic observations. Brain. 2001 Feb. 124 (Pt 2). 331-40. https://doi.org/10.1093/brain/124.2.331.

Obering C.D., Chen J.J., Swope D.M. Update on apomorphine for the rapid treatment of hypomobility (“off”) episodes in Parkinson’s disease. Pharmacotherapy. 2006 Jun. 26(6). 840-52. https://doi.org/10.1592/phco.26.6.840.

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Базові огляди, що використовувались при підготовці даної публікації

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Published

2021-11-19

How to Cite

Karaban, I., Karasevych, N., & Hasiuk, T. (2021). Prospects for successful treatment of Parkinson’s disease with the use of apomorphine. INTERNATIONAL NEUROLOGICAL JOURNAL, 17(4), 54–73. https://doi.org/10.22141/2224-0713.17.4.2021.237604

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Section

To practicing Neurologist