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........চলবে 

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.......চলবে 

Dementia থাকলেঃ

add:Rivastimine

• Tab.Demelon (1.5mg)

1+0+1........চলবে 

Psychotic symptoms (Hallucination /delusion) থাকলেঃ

add: Quetiapine

• Tab.Qutipin xr 300mg

0+0+1...... চলবে 

🀄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.