Parkinson syndrome

If you look in the medical literature, you will often see the term placebo defined as a non-specific treatment. What does it mean to say that a treatment is not specific It could mean that the treatment is effective for many different disorders, rather than for only one particular condition. In this sense, placebos are indeed non-specific. Besides depression, placebos have been shown to affect anxiety, pain, ulcers, irritable bowel syndrome, Parkinson s disease, angina, autoimmune diseases, Alzheimer s disease, rheumatoid arthritis, asthma, gastric function, sexual dysfunction and skin conditions. We know this from the thousands of studies in which placebos have been used as control conditions, against which the effects of medication have been evaluated, and from studies that were specifically designed to assess the placebo effect. 

Besides drugs, other conditions that can lead to mouth dryness are radiation against the neck, fever, concomitant diseases such as rheumatoid arthritis and other connective tissue diseases (scleroderma, sicca syndrome), Parkinson s disease, numeral psychiatric conditions and stroke with paralysis, dysphagia, neglect or oral apraxia. Damage to the mouth can arise due to drug treatment through different mechanisms and here are some examples. 

Dementia Syndromes Parkinsonism Plus Syndromes Neuromuscular Disorders Genetic/Metabolic Disorders... 

A variety of neurologic syndromes, involving particularly the extrapyramidal system, occur following short- or long-term use of neuroleptic (antipsychotic) drugs. These include akathisia, dystonia, neuroleptic malignant syndrome, parkinsonism, and tardive dyskinesia. 

Graff-Radford J, Ahlskog JE, Bower JH, Josephs KA. Dopamine agonists and Othello s syndrome. Parkinsonism Relat... 

Used in modem Europe in the treatment of premenstrual and menopausal disorders including premenstmal mastodynia (mastalgia) and other symptoms of PMS also in treatments of premenstmal tension syndrome, Parkinson s disease, acne, uterine myomas, as a galactogogue, as an adjunctive therapy in endometriosis (mckenna), and upon termination of use of birth control pills also used to help re-establish normal menstmation and ovulation, to increase or stimulate milk flow reduce water retention during menstmation allay effusions in the knee joints associated with premenstmal syndrome. 

It has been estimated that dopamine contributes at least 50% to the total CNS catecholamine content. A number of nemo-logical diseases are based on the activity of dopamine and examples include drug addiction, Tomette s syndrome, Parkinson s and Huntington s disease and schizophrenia. Fom major dopamine systems have heen identified in the brain. 

A clinical comparison has been made by Vollmer of their value in the treatment of Parkinson s syndrome. 

Antipsychotic medications are indicated in the treatment of acute and chronic psychotic disorders. These include schizophrenia, schizoaffective disorder, and manic states occurring as part of a bipolar disorder or schizoaffective disorder. The co-adminstration of antipsychotic medication with antidepressants has also been shown to increase the remission rate of severe depressive episodes that are accompanied by psychotic symptoms. Antipsychotic medications are frequently used in the management of agitation associated with delirium, dementia, and toxic effects of both prescribed medications (e.g. L-dopa used in Parkinson s disease) and illicit dtugs (e.g. cocaine, amphetamines, andPCP). They are also indicated in the management of tics that result from Gilles de la Tourette s syndrome, and widely used to control the motor and behavioural manifestations of Huntington s disease. 

EF, ejection fraction CHF, chronic heart failure WPW, Wolff-Parkinson-White syndrome DC, direct current. 

Furthermore, the presence of CB1 in the structures and pathways associated with the pathophysiology of Tourette s syndrome, and especially the functional link between CB1 and Di, D2, also argues that the endocannabinoid system may have some involvement in this disorder as well (Consroe, 1998). In addition, it has been suggested that activation of CB1 receptors, also owing to their link with the dopaminergic system, may reduce dyskinesia produced by L-DOPA in patients with Parkinson s disease (Brotsie, 1998). 

Akathisia, Parkinson-like syndrome, galactorrhea, and amenorrhea are side effects of perphenazine, caused by... 

The answer is c. (Hardman, pp 414-4163) Unwanted pharmacologic side effects produced by phenothiazine antipsychotic drugs (e.g., perphenazine) include Parkinson-like syndrome, akathisia, dystonias, galactorrhea, amenorrhea, and infertility. These side effects are due to the ability of these agents to block dopamine receptors. The phenothiazines also block muscarinic and a-adrenergic receptors, which are responsible for other effects. 

---