MY UNDERSTANDING PARKINSON’S DISEASE

SPEECH

INTRODUCTION

Mdm. Hjh Begum binti Ibrahim & my fellow classmates.

Assalammualaikum w.b.t and a very good morning.

Muhammad Ali. By looking at his picture and his name, I’m sure all of
you know him. Muhammad Ali is the most recognizable face in the world.

MEDICATION FOR PARKINSON’S DISEASE BY DRUGS THERAPY

Muhammad Ali, who was a championship boxer, was considered as one of
the best fighters of all time. Unfortunately, as is plain for the entire world to
see, Muhammad Ali is sick. He can barely speak; he can barely walk without
assistance; his hands tremble and shake. It’s almost painful to juxtapose
Muhammad Ali’s current state with that of his “float like a butterfly, sting like
a bee”. Guess, what was happening to this man. He has Parkinson’s
syndrome, a neurological condition that affects motor and speech control.

According to the book Understanding Parkinson’s disease by Richard

Rosenbaum, Kampavata which in Sanskrit means “tremor and lack of
muscular movement” is another name for Parkinson’s disease. The
symptoms of kampavata are slow movement, drooling, reptilians stare,
tremor, constant somnolence, rigidity and dementia. The question is, do
Parkinson’s disease can be cure? How it will be cure? Today, I’m standing
here to answer your questions. I’m here because I want to share with you
about the medication for Parkinson’s disease using drugs therapies which are
levodopa, dopamine agonist and enzyme inhibitors. Let’s start with levodopa
first.

1: LEVODOPA

As define by neurology health and cares, one of the drugs that use in
the medication of Parkinson is levodopa (L-dopa). Levodopa which replaces

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the dopamine is the single most effective treatment for the symptoms of
Parkinson’s disease. It is a building block in the process that brain cells use
to manufacture dopamine. L-dopa therapy usually remains effective for five
years or longer. Levodopa is so effective that some people may forget they
have Parkinson’s. But levodopa is not a cure. According to George Cotzias,
dopamine in the blood does not get into the brain. The levodopa must be use
with carbidopa. Carbidopa does not enter the brain, blocks the enzyme that
converts levodopa into dopamine in other parts of the body. By restricting

MEDICATION FOR PARKINSON’S DISEASE BY DRUGS THERAPY

the release of dopamine in the stomach, carbidopa greatly decrease the
unpleasant side effects associated with levodopa alone.

Everything has pro and contra. Although L-dopa is so effective, it

comes with side effects. Nausea and vomiting appear when the dose of
carbidopa is not large enough to control these side effects. Nausea and
vomiting effects can be reducing by taking drug with a light meal or snack.
Meanwhile, involuntary movements (dyskinesias) such as tics, twisting and
restlessness effect can only are controlled by lowering the dose of levodopa
or, doing the surgery in some cases.

2: DOPAMINE AGONISTS

Besides using levodopa as a drug theraphy, there is other way to cure

the Parkinson’s disease which is dopamine agonists. Dopamine agonists is
the chemicals that mimic the role of dopamine in the brain are commonly
used alone to treat early Parkinson’s disease or using together with levodopa
to treat advanced Parkinson’s disease. This kind of treatment imitates the
action of dopamine in the brain and cause nerve cells to react as if dopamine
were present.

There are four types’ dopamine agonists that are available in the
medication of Parkinson’s disease. The four dopamine agonists are
Pramipexole, Ropinirole, Bromocriptine, and also Pergolide. Pramipexole and

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Ropinirole are non-ergot dopamine agonists meanwhile Bromocriptine and

pergolide are ergot-derived dopamine agonists.

Pramipexole and Ropinirole may be used as a “first-line” treatment, as

a main treatment, particularly for people with young onset. At first, patients
will fall asleep while driving and it can produce daytime sleepiness when
taking one of these drugs. Meanwhile, Bromocriptine and pergolide can
cause fibrotic changes in the lungs after prolonged use but these symptoms

MEDICATION FOR PARKINSON’S DISEASE BY DRUGS THERAPY

are reversible if the drug is stopped. Besides, it also can cause a condition in
the lower legs that makes Parkinson’s patients red, hot and painful.

3: ENZYMES INHIBITORS

Now we already know two types of drug that can help in the
medication of Parkinson’s disease. I’m sure you are wondering what is the
last drug that been using in medication of Parkinson’s disease. There are two
types of enzymes inhibitor which are monoamine oxidase B (MAO-B) inhibitor
and catechol-O methyltransferase (COMT). This 2 enzymes are compounds
that impair the breakdown of dopamine and thus increase the amount of
dopamine that is available to neurons. The MAO-B inhibitors, such as
selegiline and rasagiline, prevent the enzyme MAO-B from breaking down
dopamine in the brain itself. Selegiline may delay the need for stronger
drugs, possibly by exerting a mild counter effect or by protecting neurons
from damage. Rasagiline is a newer medication that is more selective, more
potent, and has less action outside the brain, thus decreased peripheral side
effects.

The COMT is blocked or inhibited, for example, more levodopa can

reach the brain’s motor control system. The COMT inhibitor particularly
helpful for people with motor fluctuations. COMT inhibitors increase the
amount of levodopa entering the brain and prolong its effects. Entacapone
(brand name Stalevo) is a new dopamine replacement therapy that

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combines the COMT inhibitor with carbidopa/levodopa. Another COMT

inhibitor, tolcapone (brand name Tasmar), is available but has been
associated with serious liver damage in some persons.

CONCLUSION

To sum up my speech today, Parkinson’s disease is a neurological

MEDICATION FOR PARKINSON’S DISEASE BY DRUGS THERAPY

condition that gets worse over time. Although there are several ways to cure
the disease, such as drug therapy and surgical techniques, it will give the
Parkinson’s patient a numbers of side effects. According to World Health
Organization (WHO), research is continuing into the use of fetal brain tissue
implants, but as yet the results are inconclusive. But, the Parkinson’s patient
must always remains optimistic and do not blame to the God for what had
happened to them.