Morris J G
Aust Fam Physician. 1984 May;13(5 Suppl):6-8, 11.
The drug treatment of Parkinson's disease should be tailored to the age of the patient, coexistence of dementia or postural hypotension, duration of the disease process and the emergence of side effects. In the early stages of the disease when disability is minimal, amantadine or anti-cholinergic drugs may suffice. As the patient's lifestyle becomes hampered, levodopa in combination with carbidopa or benserazide is introduced. Mild dopa induced dyskinesia can be ignored but when it is troublesome the dose of levodopa should be reduced. Fluctuations are minimised by giving small doses of levodopa frequently throughout the day or by adding bromocriptine to the drug regimen. Postural symptoms often respond to fludrocortisone and elevation of the head of the bed. In elderly or demented patients anticholinergic drugs and amantadine should be avoided. In these patients small doses of levodopa alone may be preferable to the combined preparations. More effective drugs with fewer side effects are likely to emerge with future successful research into the different types of dopamine receptors and other possible transmitters.
帕金森病的药物治疗应根据患者年龄、是否并存痴呆或体位性低血压、病程长短以及副作用的出现情况进行调整。在疾病早期，残疾程度较轻时，金刚烷胺或抗胆碱能药物可能就足够了。当患者的生活方式受到影响时，可引入左旋多巴与卡比多巴或苄丝肼联合使用。轻度的多巴诱导性运动障碍可以忽略，但如果症状严重，则应减少左旋多巴的剂量。通过全天频繁给予小剂量左旋多巴或在药物治疗方案中添加溴隐亭，可将症状波动降至最低。体位症状通常对氟氢可的松和床头抬高有反应。老年或痴呆患者应避免使用抗胆碱能药物和金刚烷胺。在这些患者中，单独使用小剂量左旋多巴可能比联合制剂更可取。随着未来对不同类型多巴胺受体和其他可能递质的研究取得成功，可能会出现更有效且副作用更少的药物。
