[Practical use of continuous apomorphine infusion via pump]. 2017

Lars Tönges, and Andrés Ceballos-Baumann, and Holger Honig, and Alexander Storch, and Wolfgang H Jost
Ruhr-Universität Bochum, St. Josef-Hospital, Klinik für Neurologie.

Parkinson's disease is the second most common neurodegenerative illness after Alzheimer's disease. In its advanced stages, it is characterized by various special symptoms. In addition to non-motor signs, motor complications are most prominent and most often can only be inadequately improved with pulsatile oral therapies. However, with the aid of continuous dopaminergic stimulation, improvements can be achieved even in advanced stages of the disease. This will not only alleviate motor and non-motor symptoms, but will also lead to a better quality of life. In this context, continuous subcutaneous apomorphine administration by means of a pump has been well established. Its benefits, indications, limitations and practical implementation will be thoroughly described in the expert recommendation. Particularly noteworthy is the rather broad therapeutic window of apomorphine pump treatment, which can be optimally utilized by simple drug titration in a rapidly reversible process. This article presents the results of an expert meeting on apomorphine therapy which took place on July 6, 2016, in Frankfurt (M), Germany.

UI MeSH Term Description Entries
D010300 Parkinson Disease A progressive, degenerative neurologic disease characterized by a TREMOR that is maximal at rest, retropulsion (i.e. a tendency to fall backwards), rigidity, stooped posture, slowness of voluntary movements, and a masklike facial expression. Pathologic features include loss of melanin containing neurons in the substantia nigra and other pigmented nuclei of the brainstem. LEWY BODIES are present in the substantia nigra and locus coeruleus but may also be found in a related condition (LEWY BODY DISEASE, DIFFUSE) characterized by dementia in combination with varying degrees of parkinsonism. (Adams et al., Principles of Neurology, 6th ed, p1059, pp1067-75) Idiopathic Parkinson Disease,Lewy Body Parkinson Disease,Paralysis Agitans,Primary Parkinsonism,Idiopathic Parkinson's Disease,Lewy Body Parkinson's Disease,Parkinson Disease, Idiopathic,Parkinson's Disease,Parkinson's Disease, Idiopathic,Parkinson's Disease, Lewy Body,Parkinsonism, Primary
D011788 Quality of Life A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease. HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000978 Antiparkinson Agents Agents used in the treatment of Parkinson's disease. The most commonly used drugs act on the dopaminergic system in the striatum and basal ganglia or are centrally acting muscarinic antagonists. Antiparkinson Drugs,Antiparkinsonian Agents,Antiparkinsonians,Agents, Antiparkinson,Agents, Antiparkinsonian,Drugs, Antiparkinson
D001058 Apomorphine A derivative of morphine that is a dopamine D2 agonist. It is a powerful emetic and has been used for that effect in acute poisoning. It has also been used in the diagnosis and treatment of parkinsonism, but its adverse effects limit its use. Apokinon,Apomorphin-Teclapharm,Apomorphine Chloride,Apomorphine Hydrochloride,Apomorphine Hydrochloride Anhydrous,Apomorphine Hydrochloride, Anhydrous,Apomorphine Hydrochloride, Hemihydrate,Britaject,Apomorphin Teclapharm
D015918 Infusion Pumps, Implantable Implanted fluid propulsion systems with self-contained power source for providing long-term controlled-rate delivery of drugs such as chemotherapeutic agents or analgesics. Delivery rate may be externally controlled or osmotically or peristatically controlled with the aid of transcutaneous monitoring. Drug Delivery Systems, Implantable,Implantable Infusion Pumps,Perfusion Pumps, Implantable,Peristaltic Pumps, Implantable,Programmable Implantable Medication Systems,Implantable Medication Systems, Programmable,Medication Systems, Programmable Implantable,Systems, Programmable Implantable Medication,Implantable Infusion Pump,Implantable Perfusion Pump,Implantable Perfusion Pumps,Implantable Peristaltic Pump,Implantable Peristaltic Pumps,Infusion Pump, Implantable,Perfusion Pump, Implantable,Peristaltic Pump, Implantable,Pump, Implantable Infusion,Pump, Implantable Perfusion,Pump, Implantable Peristaltic,Pumps, Implantable Infusion,Pumps, Implantable Perfusion,Pumps, Implantable Peristaltic

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