Parkinson's Disease

Clinical Features:

• 1)bradykinesia
• 2)rest tremor,
• 3)rigidity
• 4)postural and gait impairment.

investigation:

• 1)Cranial CT 
• 2)MRI 

Rx:

☑️Counselling the pt about disease 

☑️Physical therapy may helpful 

1)Tab.Codopa(10/100mg)(carbidopa+levodopa)

• 1+1+1......continue

Most effective for aakinesia and rigidity.

Tremor ওত ভাল কমায় না।

if Tremor :

add: anticholinergic drug

Tab.Hexinor 2mg(trihexyphenidyl)

• 1/2+0+1/2.........continue

if  Dyskinasia/Motor fluctuations :

add: non ergot dopamin agonist

Tab.Ropinolol (0.25mg)(ropinirole)

• 1+1+1......7days then 

Tab.Ropinolol(0.5mg)

• 1+1+1........continue

Dementia থাকলেঃ

add:Rivastimine

Tab.Demelon (1.5mg)

• 1+0+1........continue

Psychotic symptoms (Hallucination /delusion) থাকলেঃ

add: Quetiapine

Tab.Qutipin XR 300mg

• 0+0+1...... .continue

🀄if no improved in medical treatment then refered to surgery 

Advice: 

• 1)Exercise Regularly.
  
• 2)Be Fall Savvy.
• 3)Sleep Well.
• 4)Eat for Health.