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Biomedical subjects

F Stocchi

Publications and source records attributed to F Stocchi.

At least 91 records · Page 5Linked to original sources
PubMed1988

Comparison between L-dopa and lisuride intravenous infusions: a clinical study.

L-Dopa is still the most effective drug for the treatment of Parkinson's Disease, but after 5 years or more of therapy fluctuations in motor performance and abnormal involuntary movements commonly appear. Continuous intravenous infusions of L-Dopa abolish or strikingly reduce such fluctuations. Unfortunately, this is not suitable for daily treatment because of the low solubility of L-Dopa. Lisuride is a potent dopamine agonist and is very soluble in water. In this study the clinical effects of L-Dopa and lisuride continuous intravenous infusions were compared in a group of 20 fluctuating parkinsonian patients. L-Dopa controlled fluctuations in almost all the subjects, whereas only seven patients were continuously mobile while taking lisuride. Another seven patients showed a fluctuating response and the remaining six did not satisfactorily respond to lisuride. Dyskinesias were present in all patients during "on" phases, with both levodopa and lisuride treatment.

Adult↗
PubMed1988

Subcutaneous lisuride infusion in Parkinson's disease: clinical results using different modes of administration.

The continuous dopaminergic stimulation provided by infusion of dopamine agonist drugs, is a very effective strategy to control ON-OFF fluctuation in Parkinson's disease. Lisuride is a potent dopamine agonist drug, very soluble in water and can be administered subcutaneously. Many authors have shown that the subcutaneous infusion of lisuride can control fluctuations when applied in combination with oral levodopa as a 24 hour continuous infusion regimen. In this study, lisuride was given without any other antiparkinsonian medicament and using a 12 hour infusion regimen wherever possible. 13 fluctuating Parkinsonian patients were studied. 6 out of these 13 were satisfactory treated with lisuride alone and the remaining 7 with a combination of Lisuride + oral levodopa. Only in 3 out of 13 patients the 24 hour infusion regimen was required.

Administration, Oral↗
PubMed1988

Pharmacokinetics of lisuride after subcutaneous infusion.

Six parkinsonian patients received a constant subcutaneous infusion of 60 micrograms lisuride per hour in the abdominal region for 2 hours. Plasma levels of the unchanged drug were measured by radio-immunoassay. During infusion, a steady state plasma level of 0.78 +/- 0.19 ng/ml was achieved. After discontinuation of the infusion, concentrations declined with a half-life of 1.4 +/- 0.4 hour. The total clearance of lisuride was 20 +/- 6 ml/min/kg. Due to the low interpatient variability of plasma levels, a good control of clinical effects is to be expected.

Administration, Oral↗
PubMed1987

Corneal and blink reflexes in Parkinson's disease with "on-off" fluctuations.

In 13 patients with Parkinson's disease and "on-off" fluctuations and in a control group, the electrically evoked blink (R1 and R2 component) and corneal reflexes (CR), the habituation of the glabellar reflex, and the blink rate were studied. Latency, amplitude, and recovery cycle of R1 was normal. CR latency, but not R2 latency, was significantly shorter in patients than in normal subjects. R2 recovery cycle, but not CR recovery cycle, was facilitated in "off" patients in comparison to normal subjects. CR and R2 duration was longer in "off" than in "on" patients. R2 recovery cycle became similar to that of normal subjects after fluctuation from "off" to "on" period, but CR recovery cycle varied only slightly. The habituation of the glabellar reflex and the blink rate were decreased in "off" patients. These findings indicate that the enhanced excitability of R2 is related to the central dopamine activity levels. The differences between the recovery cycles of CR and R2 may be explained with the smaller number of interneurons subserving CR than R2 circuit. The shorter latency of CR, but not of R2, both in "on" and "off" patients, may suggest that in Parkinson's disease basal ganglia exert a different control of incoming sensory input transmitted via beta and delta fibers.

Adult↗
PubMed1987

Single-dose studies of a slow-release preparation of levodopa and benserazide (Madopar HBS) in Parkinson's disease.

The clinical effects and pharmacokinetic profiles of single doses of Madopar HBS were compared with those of standard Madopar in two studies in patients with Parkinson's disease and 'on-off' fluctuations. In the first study, 10 fasting patients received equivalent doses (200 mg levodopa plus 50 mg benserazide) of each preparation. The clinical response to Madopar HBS was delayed and brief; the relative bioavailability was only 50%. In the second study in 7 non-fasted patients, the effects of 3 capsules of Madopar HBS 125 were compared with those of 2 capsules of standard Madopar 125. Delay to turn on was longer with HBS, but duration of time on, and delay to turn off, were longer with this preparation. The area under the concentration-time curve for plasma levodopa was greater with HBS, and the maximum levodopa concentration was similar to, but achieved later than standard Madopar.

Administration, Oral↗
PubMed1986

Multicenter trial of L-Deprenyl in Parkinson disease.

A multicenter trial was conducted at 9 Neurology Departments to evaluate the action of L-Deprenyl, a specific monoamine oxidase-B inhibitor, combined with L-Dopa in the treatment of Parkinson disease. In all, 76 patients were treated, 33 women and 43 men, on stable treatment with L-Dopa+ aromatic decarboxylase inhibitors (DI) for at least 6 months. After a 50% reduction of the L-Dopa dose, all received L-Deprenyl 5 mg twice daily for 35 day. The combined treatment resulted in a definite improvement in rigidity, bradykinesia and, most of all, tremor. Further, at the end of treatment fewer patients had depressive symptoms and the total daily number of hours of wellbeing and normal movement increased. 12 patients presented modest side effects, in no case serious enough to warrant suspension of treatment. The trial shows that with the L-Deprenyl + L-Dopa combination the dose of L-Dopa needed to control the disease can be drastically reduced.

Adult↗
PubMed1986

Repeated levodopa infusions in fluctuating Parkinson's disease: clinical and pharmacokinetic data.

The short-term efficacy of continuous intravenous infusions of levodopa (with oral peripheral decarboxylase inhibitor) in abolishing or reducing "on-off" fluctuations in patients with Parkinson's disease is well established. However, there are suggestions that clinical response may be less good with longer infusions, or infusions on consecutive days. We therefore gave intravenous infusions of levodopa to three such subjects on five consecutive days (6 h on day 1, 12 h/day on days 2 to 5). One subject's symptoms were perfectly controlled, one experienced one "off" period per day, and the third developed one or two off-periods per day. Nevertheless, clinical control in all three subjects was superior with levodopa infusions to that seen on optimum oral therapy. Plasma levodopa concentrations during the infusions could be correlated with off to on, and with on to off switches. In general, subjects needed higher plasma levodopa levels to turn "on" than to keep them mobile once on, and the threshold levels below which off-periods supervened were lower still. These experiments show that repeated intravenous infusions of levodopa are very effective in some parkinsonian subjects, who may be suitable candidates for prolonged parenteral treatment with alternative, more highly soluble, dopaminergic drugs.

Drug Administration Schedule↗
PubMed1986

The role of MAO-b inhibitors in the treatment of Parkinson's disease.

The classical treatment of Parkinson's disease (PD) using L-dopa plus a peripheral decarboxylase inhibitor (DI) often leads after 3-5 years to the onset of the so-called long-term L-dopa syndrome (LTS). LTS could depend on the chronic overload of L-dopa + ID and could be due to a consequent "receptor disease" and derangement of the neuronal functionality mainly in regard to the enzymatic chains, storage mechanisms and hyperactivity of the monoamine oxidase type B (MAO B). Deprenyl is a selective MAO-B inhibitor thought to be able to slow down the catabolism of dopamine and therefore to allow a decrease of the therapeutic regimen of L-dopa while in the meantime to obtain a more stable plasma and tissue levels and a constant therapeutic response. 76 parkinsonian patients were studied. Their L-dopa regimen was halved and 10 days after (-)deprenyl was added. After the decrease of L-dopa therapy a worsening of symptomatology was observed as expected. The association with (-)deprenyl was able to reverse this trend and when the inhibition of MAOB was really effective patients showed an improvement of symptoms even when compared to baseline values. No relevant side effects were observed and no patients dropped out.

Adult↗
PubMed1986

Problems in daily motor performances in Parkinson's disease: the continuous dopaminergic stimulation.

Fluctuations in motor performances are the major problem in the longterm management of Parkinson's disease. In this study the clinical effects of L-dopa intravenous infusion were evaluated in 18 parkinsonian patients with fluctuations. 14 out of these were given Lisuride intravenous infusion in a following study. Lisuride is a potent dopamine agonist and it is highly soluble in water. The results obtained with L-dopa were very good and we found a close correlation between oral and intravenous dosage. The dosage of L-dopa infusion ranged between 360-1,250 mg for 12 hours. Lisuride proved to be able to give prolonged mobile state in 8 patients out of 14. The other 6 patients showed a different response to the drug. The dosage used ranged between 0.6 and 2.4 mg per day. No severe side-effects were observed during both studies except for nausea and vomiting occurring during Lisuride infusion.

Administration, Oral↗