Panegyres P K, Graham S J, Williams B K, Higgins B M, Morris J G
Department of Neurology, Westmead Hospital, NSW.
Med J Aust. 1991 Sep 16;155(6):371-4. doi: 10.5694/j.1326-5377.1991.tb101311.x.
To compare the effects of single doses of oral levodopa, subcutaneous apomorphine and sublingual apomorphine.
Single-blind placebo-controlled comparative study.
Subjects were admitted as day patients to the neurology ward.
Five patients with idiopathic Parkinson's disease and "end of dose deterioration" entered and completed the study.
Patients were given domperidone (20 mg by mouth three times a day) to prevent nausea and apomorphine (1-3 mg by subcutaneous injection), apomorphine in glycerol (10-30 mg sublingually) or their usual levodopa regimen.
Efficacy, time to onset of effect and duration of effect of oral levodopa, subcutaneous apomorphine and sublingual apomorphine. Tremor amplitude and timed pegboard and gait tasks were used as objective indices of clinical state.
Maximal efficacy of the three treatments was comparable (P = 0.28-0.99). Mean latency to onset of effect of both formulations of apomorphine was less than that of levodopa (P = 0.022-0.048) but so was the duration of effect (P = 0.044-0.049).
Sublingual apomorphine may be a convenient means of rapidly terminating "off" periods associated with long term levodopa therapy.
比较单次口服左旋多巴、皮下注射阿扑吗啡和舌下含服阿扑吗啡的效果。
单盲安慰剂对照比较研究。
受试者作为日间患者入住神经内科病房。
五名患有特发性帕金森病且出现“剂末恶化”的患者进入并完成了研究。
给予患者多潘立酮（口服20毫克，每日三次）以预防恶心，并给予阿扑吗啡（皮下注射1 - 3毫克）、甘油阿扑吗啡（舌下含服10 - 30毫克）或其常规左旋多巴治疗方案。
口服左旋多巴、皮下注射阿扑吗啡和舌下含服阿扑吗啡的疗效、起效时间和作用持续时间。震颤幅度以及定时插板和步态任务被用作临床状态的客观指标。
三种治疗的最大疗效相当（P = 0.28 - 0.99）。两种阿扑吗啡制剂的平均起效潜伏期均短于左旋多巴（P = 0.022 - 0.048），但作用持续时间也是如此（P = 0.044 - 0.049）。
舌下含服阿扑吗啡可能是快速终止与长期左旋多巴治疗相关的“关”期的一种便捷方法。
