Rational Drug Use And Parkinson Disease

摘要

Aim: Parkinson's disease (PD) is a neurodegenerative disease characterized by increased activity of GABA in basal ganglia and the loss of dopamine in nigrostriatum, associated with rigidity, resting tremor, gait with accelerating steps, and fixed inexpressive face.(1) Current treatments mostly aim to have the symptoms under control. The treatment of the disease can be done accurately when it is integrated with especially patient compliance and all sub-disciplines of pharmacology like drug interactions, pharmacovigilance and pharmacoeconomy. It is aimed in this study to analyse the age when the disease was determined, comorbid diseases, drug use and adverse effects in patients who were diagnosed Parkinson disease and whose treatment already started and to research the Vitamin B12, TSH, Triglyceride, Folic Acid levels that are related with the disease in the literature. Method: The study was conducted on 111 patients who had applied to Kütahya Dumlupynar University Medical Faculty Evliya ?elebi Education & Research Hospital between 2006 and 2013 and were diagnosed Parkinson disease. The following data of the patients- age, gender, drugs having been used, treatments related with the comorbid diseases, adverse effects, B12 vitamin values in the files of 44 patients, their Triglyceride levels, TSH and Folic acid levels- were reviewed retrospectively from their follow-up files. Findings: The participants of the study were 111 subjects diagnosed Parkinson disease and 47 of them (42,3%) were female while 64 (57,7%) were male. The age range during which the disease was seen frequently was (65-74) and the age average was 64 (25-86). 107 (96,3%) of the 111 subjects were started with antiparkinson treatment. In terms of the comorbid diseases to Parkinson, no comorbid diseases were determined in 78 (70,2%) of the 111patients while depression was seen in 8 (%24,4) subjects, hypothyroidis was seen in 13 (39,4%) subjects, DM was seen in 7 (21,2%) subjects, hyperlipidaemia was seen in 2 (6,2%) subjects. 40 (36%) of the patients didn't use any additional drugs, but additional drug use was determined in 71 (63%) patients. In terms of the data of the 44 patients, whose laboratory data could be obtained, it was found that that on average B12 value was 412.53 and TSH value was1.48 while Folate value was 9.35 and TG value was 131.56. In these 44 patients, B12 value of 32 (73%) patients, TSH value of 24 (55%) patients, Folate value of 30 (68%) patients were low, whereas TG value of 23 (47%) was low. Discussion & Conclusion: Rational drug use is extremely crucial in the treatment of Parkinson disease. One of the most important factors in the treatment success is compliance with the treatment. A careful follow up of folate, B12, TSH, Triglyceride levels related to the disease in the literature in patients diagnosed Parkinson disease and taking the required precautions will provide synergistic contribution to the treatment success.