Cohen M M, Scheife R T
Am J Hosp Pharm. 1977 May;34(5):531-8.
The pathophysiology, anticholinergic therapy and dopaminergic therapy of Parkinson's disease are reviewed; an emphasis is placed on the structure and function of the basal ganglia because of their importance in understanding the pharmacotherapy of parkinsonism. The pharmacologic management of Parkinson's disease is limited primarily to manipulation of the dopamine-acetylcholine system. Levodopa, with or without a peripheral dopa decarboxylase inhibitor, is the current drug of choice in the management of idiopathic and postencephalitic Parkinson's disease. Modification of the serotonin-histamine system via the use of antihistamines may be useful in some patients. There are also many adjunctive agents which may be employed in combination with or in place of levodopa. Levodopa clearly has no place in the treatment of neuroleptic-induced Parkinson's disease; anticholinergics and antihistamines are the agents of choice.
本文综述了帕金森病的病理生理学、抗胆碱能治疗和多巴胺能治疗；鉴于基底神经节在理解帕金森病药物治疗方面的重要性，重点阐述了其结构和功能。帕金森病的药物治疗主要局限于对多巴胺 - 乙酰胆碱系统的调控。左旋多巴，无论是否联用外周多巴脱羧酶抑制剂，都是目前治疗特发性和脑炎后帕金森病的首选药物。对于某些患者，通过使用抗组胺药来调节血清素 - 组胺系统可能会有帮助。此外，还有许多辅助药物可与左旋多巴联合使用或替代左旋多巴。左旋多巴在治疗抗精神病药物所致帕金森病中显然无效；抗胆碱能药物和抗组胺药是首选药物。
