Parkinsonova bolest - terapijske mogućnosti

master's thesis

• Title (english): Parkinson disease - treatment options
• Author: Marko Marasović
• Mentor: Petra Turčić (mentor)
• Committee member: Petra Turčić (predsjednik povjerenstva)
• Committee member: Lidija Bach-Rojecky (član povjerenstva)
• Committee member: Dubravka Vitali Čepo (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of pharmacology); Zagreb
• Defense date and country: 2016-11-03, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Glavni cilj ovog diplomskog rada bio je prikazati izazove u liječenju Parkinsonove bolesti, kao jednog od čestih poremećaja pokreta s visokim stupnjem onesposobljenja oboljelih. Specifični ciljevi bili su: opisati kliničku sliku Parkinsonove bolesti, ukazati na važnost prepoznavanja simptoma te ranog i ispravnog dijagnosticiranja bolesti te farmakološki okarakterizirati skupine lijekova koje se najviše koriste u liječenju.
U radu je opisan farmakološki profil osnovnih skupina lijekova koji se koriste za liječenje Parkinsonove bolesti. Među njima, dopaminski agonisti imaju važnu ulogu u liječenju parkisonizma i lijekovi su prvog izbora, a koriste se još levodopa s karbidopom te MAO-B i COMT inhibitori. Kod bolesnika mlađe dobi odnosno u onih s blažim oblikom bolesti može se započeti sa selegilonom jer ima neuroprotektivno djelovanje te usporava progresiju bolesti. Kontrola unosa proteina prehranom također pomaže umanjiti fluktuacije terapijskog odgovora. Duboka stimulacija mozga obično pomaže bolesnicima koji na farmakoterapijske intervencije nisu reagirali.
Pacijent i njegova obitelj mogu prolaziti kroz zahtjevan period te im svakako treba biti pružena emocionalna i društvena potpora. Gubitak fizičke pokretljivosti uz promjenu osobnosti može biti nešto s čime se vrlo teški nosi unutar obitelji. Uključenost fizikalnih terapeuta, socijalnih radnika i stručnjaka za palijativnu skrb je veoma bitna.
Farmaceut ima važnu i odgovornu ulogu u provođenju skrbi o bolesnicima s Parkinonovom bolesti. Kao najdostupniji zdravstven djelatnik, u prilici je kontrolirati farmakoterapiju i savjetovati o njenom racionalnom provođenju, ali i kroz razvijen povjerljiv odnos s pacijentom, utjecati na adherenciju te tako doprinjeti postizanju željenog terapijskog cilja s minimalnim rizicima od neželjenih i toksičnih učinaka.

Abstract (english)

The main aim of this thesis was to present challenges in the treatment of Parkinson's disease as one of the most common movement disorders with a high degree of disability of patients. Specific aims were: to describe the clinical features of Parkinson's disease, point out the importance of recognizing symptoms and early and correct diagnosis, and pharmacologically characterize the group of drugs that are most commonly used in the treatment
This paper describes the pharmacological profile of the basic groups of drugs used to treat Parkinson's disease. Among them, dopamine agonists have an important role in the treatment of Parkinsonism and they are the main therapy, but levodopa with carbidopa, MAO-B and COMT inhibitors are also used. Patiens with are younger age and with those who have mild forms of the disease can start the treatment with selegiline because of his neuroprotective effect and slowing the progression of the disease. Control of dietary proteine intake also helps reducing fluctuations in therapeutic response. Deep brain stimulation usually helps patients who did not respond to pharmaceutic interventions.
The patient and his family can go through a demanding period and they should certainly be given an emocional and social support. The loss of physical mobility with the change of personality may be something that is very difficult to cary within the family. The involvement of physical therapists, social workers and specialists in palliative care is important.
The pharmacist has an important and responsible role in providing optimal care for patients with Parkinson's disease. As the most accessible health care provider, pharmacist is able to control pharmacotherapy and advise on its rational implementation, but also through confidential relationship with the patient, influence the adherence and thus contribute to achieving therapeutic goal with minimal risks of unwanted and toxic side effects.

• Keywords: Parkinsonova bolest; parkinsonizam; MAO-B inhibitori; COMT inhibitori; agonisti dopaminskih receptora; levodopa; karbidopa; antikolinergici; tremor; amantadin; duboka stimulacija mozga
• Keywords (english): Parkinson's disease; Parkinsonism; MAO-B inhibitors; COMT inhibitors; dopamine receptor agonists; levodopa; carbidopa; anticholinergics; tremor; amantadine; deep brain stimulation
• Language: croatian
• URN:NBN: urn:nbn:hr:163:477737
• Study programme: Title: Pharmacy; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Access restricted to students and staff of home institution
• Created on: 2016-12-06 13:08:54