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Parenterale Therapie mit Dopaminagonisten

  • W. Poewe

Zusammenfassung

Mehr als 50% der Patienten mit einer Parkinsonkrankheit die über mehr als 5 Jahre mit einer klassischen L-Dopa-Monotherapie behandelt werden, entwickeln Wirkungsfluktuationen in Form von „wearing-off“-und „on-off“-Schwankungen (Marsden et al. 1982, Poewe et al. 1986). Während wearing-off-Fluktuationen auf eine Reihe von Maßnahmen wie VerkÜrzung der Dosierungsintervalle, Addition von MAO-B-Hemmern oder Dopaminagonisten, Gabe von L-Dopa-Retard-Präparaten oder COMT-Hemmern ansprechen (Marsden 1994, Ruotinnen und Rinne 1996, Kurth et al. 1997, Baas et al. 1997), sind komplexe Wirkungsfluktuationen schwerer zu beherrschen. Letztere betreffen mindestens 10% der fluktuierenden Parkinsonpatienten und entwickeln sich oft aus einem wearing-off-Muster (Marsden und Parkes 1977). Eine kontinuierliche parenterale Verabreichung für ein L-Dopa mittels i.v.-Dauerinfusionen kann aber auch bei solchen Patienten mit refraktären on/off-Fluktuationen zu einem deutlichen Ausgleich der Wirkungsschwankungen führen (Quinn et al. 1984).

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© Springer-Verlag Wien 1999

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  • W. Poewe

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