帕金森病-中西医内科—培训课件.pptVIP

* The most common motor fluctuation is a regular and predictable wearing off two to four hours after an immediate-release levodopa dose. This is most easily treated by increasing levodopa dosing frequency or changing to the controlled-release preparation. Furthermore it may also be effective to reduce the total dose of levodopa and add a dopamine agonist or COMT inhibitor. * Factors that influence peripheral levodopa kinetics include delayed gastric emptying, competition from dietary protein and the short plasma half-life of the traditional “immediate release” levodopa. Central causes of moto