OrganismsDiseasesChemicals and DrugsAnalytical, Diagnostic and Therapeutic Techniques and EquipmentPsychiatry and PsychologyPhenomena and Processes
Infusions, SubcutaneousInfusion PumpsApomorphineInsulin LisproInjections, SubcutaneousInfusions, ParenteralInsulin Infusion SystemsDopamine AgonistsRats, Sprague-DawleyInfusions, IntravenousReceptors, DopamineAngiotensin IIInsulinBlood PressureHaloperidolPiribedilEmeticsPenile ErectionPimozideStereotyped BehaviorDopamine AntagonistsStartle ReactionDopamineLevodopaAntiparkinson AgentsReceptors, Dopamine D2Catalepsy
CSAIMotor FluctuationsParkinson'sDopaminergic stimulationDopamine agonistTitrationLevodopaInjectionOralReactionsTreatmentEffectsLocalAdministrationFluctuating Parkinson's diseaseLevodopaDopamineLCIGAgonistInjectionsPumpNodulesInsulinDopaminergicDoseTherapiesClinicalPatientsStimulationMedicationDrugEffectsPeriod
CSAI5
  • Continuous subcutaneous apomorphine infusion (CSAI) is increasingly used in Parkinson's disease (PD), notably in patients contraindicated for subthalamic deep brain stimulation. (konexionsnc.com)
  • Continuous subcutaneous apomorphine infusion (CSAI) is a safe and effective way of reducing off time in patients with Parkinson's disease (PD) whose motor complications are suboptimally controlled by oral medication [ 1 ] and treating severe insomnia in patients with fluctuating PD [ 2 ]. (e-jmd.org)
  • The effects of CSAI on motor complications (Unified Parkinson's Disease Rating Scale [UPDRS]) and quality of life (Parkinson's Disease Questionnaire-39 [PDQ-39]) were evaluated at 1 year, 5 years and 12 years ( Figure 1B and C ). After a few weeks, she could manage the pump device without the help of a caregiver, and she has never complained of major side effects related to apomorphine. (e-jmd.org)
  • Continuous Subcutaneous Apomorphine Infusion (CSAI), despite being approved for the treatment of APD since 1993, was approved in India only in 2019. (bvsalud.org)
  • Patients with APD, not responding to or with significant side effects from oral dopaminergic therapy, were assessed at baseline and at month 6 and 12 following CSAI infusion. (bvsalud.org)
Motor Fluctuations1
  • Continuous infusion of levodopa or apomorphine provide constant dopaminergic stimulations are good alternatives to deep brain stimulation to control motor fluctuations in patients with advanced Parkinson's disease (PD). (e-jmd.org)
Parkinson's5
  • Apomorphine Monotherapy for Parkinson's Disease: A Neglected Option? (e-jmd.org)
  • Bhidayasiri R, Boonpang K, Jitkritsadakul O Understanding the role of the Parkinson's disease nurse specialist in the delivery of apomorphine therapy. (britishjournalofcommunitynursing.com)
  • Apomorphine is the most potent dopamine agonist that provides anti-Parkinson's effect comparable to levodopa, and potentially improves dyskinesia. (mdsabstracts.org)
  • Introduction: When advanced Parkinson's disease (PD) patients experience motor complications (fluctuations and dyskinesias) despite standard oral treatment, two treatment options are available: deep brain stimulation and subcutaneous apomorphine infusion with respects of indications for each strategy. (modem-dementia.org.uk)
  • Why do 'OFF' periods still occur during continuous drug delivery in Parkinson's disease? (e-jmd.org)
Dopaminergic stimulation1
  • However, this procedure is more invasive than apomorphine as it requires a percutaneous endoscopic gastrostomy Clinical experience with infusions shows that continuous dopaminergic stimulation of dopaminergic medications reduces dyskinesia and widens the therapeutic window in advanced PD. (e-jmd.org)
Dopamine agonist1
  • Apomorphine is a nonergoline dopamine agonist indicated for the acute, intermittent treatment of hypomobility "off" episodes ("end-of-dose wearing off" and unpredictable "on/off" episodes) associated with advanced PD. (medscape.com)
Titration1
Levodopa1
  • Administration of levodopa/carbidopa by continuous duodenal infusion allows replacement of all oral medications and permits achievement of a satisfactory therapeutic response paralleled by a reduction in motor complication severity. (e-jmd.org)
Injection2
  • Apomorphine provides motor benefit similar to dopamine, but its long-term use is limited by compliance, mostly injection site skin reactions. (e-jmd.org)
  • It is administered by a subcutaneous injection. (medscape.com)
Oral1
  • After 3 months, she was no longer taking oral medication, and the daily dose of apomorphine was 168 mg. (e-jmd.org)
Reactions2
  • For the evaluation of local site reactions, four drug formulations, 1% ND0701, 2.5% ND0701, 0.5% apomorphine-HCl or 1% apomorphine-HCl, were administered by subcutaneous continuous infusion of 50 mg apomorphine during 24h, at a volume of 5, 2, 10 and 5 ml, respectively. (mdsabstracts.org)
  • MRI analysis showed that local site reactions following continuous subcutaneous administration of ND0701, at concentrations as high as ×2.5-5 than those of Apomorphine-HCl, were significantly smaller and exhibited better recovery. (mdsabstracts.org)
Treatment1
  • Our study highlighted current existing inequalities in treatment availability, lack of awareness, knowledge gap, affordability and cost remains a concern regarding apomorphine use in Indian PD population. (bvsalud.org)
Effects1
  • Although the exact mechanism by which apomorphine exerts its therapeutic effects in PD is unknown, it is thought to occur via activation of postsynaptic D2 receptors in the striatum. (medscape.com)
Local1
  • Local anesthetic can be used to create a cutaneous/subcutaneous wheel for local pain control. (abcmedicalnotes.com)
Administration1
  • Histopathological evaluation supported these findings showing only a minimal, chronic inflammatory reaction following continuous subcutaneous administration of 1% and 2.5% ND0701, while mild, chronic, granulomatous inflammation and necrosis of the subcutis were observed following Apomorphine-HCl administration. (mdsabstracts.org)
Fluctuating Parkinson's disease1
  • Subcutaneous apomorphine is currently used for the management of sudden, unexpected and refractory levodopa-induced 'off' states in fluctuating Parkinson's disease either as intermittent rescue injections or continuous infusions. (nih.gov)
Levodopa14
  • Except for a rapid on- and offset of the antiparkinsonian response with subcutaneous apomorphine, the magnitude and pattern of the motor response to single dose of subcutaneously administered apomorphine is qualitatively comparable to that of oral levodopa. (nih.gov)
  • The efficacy of intermittent subcutaneous apomorphine injections as an add-on to levodopa therapy in advanced Parkinson's disease was explored in one short-term, randomised, double-blind, placebo-controlled trial, one short-term and six long-term, open-label, uncontrolled studies, including a total of 195 patients. (nih.gov)
  • Continuous infusion of levodopa-carbidopa intestinal gel (LCIG) has shown promising results in alleviating motor fluctuations and improving quality of life. (bvsalud.org)
  • or carbidopa-levodopa enteral suspension), continuous intrajejunal delivery of levodopa-carbidopa-entacapone intestinal gel, or continuous subcutaneous apomorphine infusion. (bvsalud.org)
  • OBJECTIVES : The objectives of this analysis were to evaluate cost-utility of continuous subcutaneous apomorphine infusion (Apomorphine) + Levodopa tablet (tab. (hsri.or.th)
  • RESULTS: Base on societal perspective, Apomorphine + Levodopa could reduce off-time and delay disability which resulted in increasing life years and quality of life compared with Entacapone tab. (hsri.or.th)
  • CONCLUSIONS: Based on the willingness to pay threshold 160,000 THB/QALY, Apomorphine + Levodopa and Rasagiline + Levodopa would not be cost-effective compared with Entacapone tab. (hsri.or.th)
  • Research comparing levodopa/carbidopa intestinal gel (LCIG), deep brain stimulation (DBS), and continuous subcutaneous apomorphine infusion (CSAI) for advanced Parkinson's disease (PD) is lacking. (parkinsons-london.co.uk)
  • Consecutive advanced PD patients treated with levodopa/carbidopa intestinal gel (LCIG) or continuous subcutaneous apomorphine infusion (CSAI) or care as usual (CU) and their care partners were recruited during routine visits according to a cross-sectional design. (open.ac.uk)
  • Three device-aided treatments are currently available to provide different kinds of continuous stimulation: levodopa/carbidopa intestinal gel infusion, deep brain stimulation (DBS), and subcutaneous apomorphine pump infusion (not approved in US). (pd-thrive.com)
  • Long-Acting, Subcutaneous Levodopa In Parkinson's Disease: Is It Safe? (medscape.com)
  • This was an open-label, subcutaneous infusion of foscarbidopa/foslevodopa ( ABBV-951 ), which is the preparation for subcutaneous infusion of levodopa, which was delivered as the therapeutic drug. (medscape.com)
  • and adjunctive medications and Duopa , which is an intestinal infusion of carbidopa/levodopa. (medscape.com)
  • But keep in mind that this is the first time there's been a subcutaneous levodopa experimental therapeutic like this, where we're trying to deliver it in a very different way. (medscape.com)
Dopamine5
  • Dopamine produces nausea and vomiting by stimulation of the medullary chemoreceptor trigger zone (CTZ), and metoclopramide blocks stimulation of the CTZ by agents like l-dopa or apomorphine which are known to increase dopamine levels or to possess dopamine-like effects. (nih.gov)
  • Aged animals with unilateral 6-hydroxydopamine (6-OHDA) lesions have been reported to show decreased rotation following contralateral striatal dopamine infusion or systemic apomorphine. (baillement.com)
  • We have examined the effects of ageing on the motor behaviours elicited by a range of doses of the classical D1/D2 dopamine agonist apomorphine in the rat. (baillement.com)
  • In view of the known loss of nigrostriatal dopamine neurons and decreases in striatal dopamine that occur with ageing, we predicted a decrement in apomorphine-induced yawning and penile grooming , responses that are thought to result from stimulation of autoreceptors located on dopamine nerve terminals. (baillement.com)
  • Pharmacological stimulation of dopamine systems demonstrated an age-related decrement in yawning , but an increase in stereotyped sniffing and licking or gnawing induced by the mixed D1/D2 agonist apomorphine. (baillement.com)
LCIG3
  • MATERIAL AND METHODS Forty-three PD patients who were candidates for LCIG therapy underwent transgastric jejunostomy to facilitate continuous infusion of LCIG. (bvsalud.org)
  • RESULTS The results of this study demonstrated significant improvements in motor symptoms, reduction in motor fluctuations, and enhanced quality of life following PEG-J for LCIG infusion. (bvsalud.org)
  • Notably, the use of PEG-J allowed for precise and continuous delivery of LCIG, minimizing variations in drug absorption and ensuring consistent therapeutic levels. (bvsalud.org)
Agonist2
  • Apomorphine, a dopaminergic agonist was given over a period of 12 months to 14 parkinsonian patients suffering from severe L-dopa induced on-off effects. (nih.gov)
  • Finally, in order to better appreciate whether the effects of ageing on the responses to apomorphine reflect alterations in D1 or D2 receptors, the locomotor stimulant effects of 14 days of continuous infusion of the selective D2 agonist (+)-4-propyl-9-hydroxynaphthoxazine (PHNO) were also investigated. (baillement.com)
Injections1
  • mean age at onset of the disease: 37 years), were treated by continuous infusion with a portable minipump, and 5 others by multiple injections with a penject. (nih.gov)
Pump2
  • So the whole idea here is that this treatment ABBV-951 is a subcutaneous continuous infusion via a pump. (medscape.com)
  • Use an infusion pump with 50 U Actrapid in 50ml with NS. (abcmedicalnotes.com)
Nodules3
  • Red fibrous subcutaneous nodules occurred at the injection sites in all patients treated by infusion. (nih.gov)
  • Ultimately, the group noted that the majority of these nodules can be managed conservatively, with Isaacson et al suggesting that patients report any infusion-site reactions that do not improve, expand, or are associated with systemic symptoms to their clinicians. (neurologylive.com)
  • As infections are uncommon in the instance of infusion-site reactions/nodules, the group suggested that empiric antibiotics "were not felt to be necessary in most circumstances. (neurologylive.com)
Insulin3
  • But when we went back and looked at some of the literature for other subcutaneous infusions, whether it was insulin or subcutaneous apomorphine, you see a lot of skin reactions, particularly when people are starting out. (medscape.com)
  • Start fixed rate IV Insulin infusion (FRIII) weight adjusted in kilograms. (abcmedicalnotes.com)
  • ideally give subcutaneous fast-acting insulin and a meal, and stop the insulin infusion 1 hour later. (abcmedicalnotes.com)
Dopaminergic2
  • Other indications include the challenge test for determining the dopaminergic responsiveness and finding the appropriate dose of the drug in intermittent subcutaneous administration. (nih.gov)
  • Continuous dopaminergic stimulation is a new strategy aimed at decreasing motor fluctuations in advancing PD. (pd-thrive.com)
Dose3
  • These patients received a mean apomorphine daily dose of 93 mg and L-dopa dosage was reduced by 53 p. 100. (nih.gov)
  • Seventy-five percent of patients achieve a clinically significant improvement with a dose of apomorphine 4mg. (nih.gov)
  • The other drugs had the stay level, but the infusion foscarbidopa/foslevodopa was adjusted for a period of up to 4 weeks and then then the dose was maintained for 48 weeks. (medscape.com)
Therapies2
  • The panel of movement disorder specialists and dermatologists offered a framework of suggestions for the supervision of the most common infusion-site reaction associated with these therapies. (neurologylive.com)
  • Consideration and initiation of infusion therapies in advanced PD are suggested before the onset of major disability. (bvsalud.org)
Clinical1
  • The present review summarizes clinical evidence for infusion therapy in advanced PD management, discusses available screening tools for advanced PD, and provides considerations around optimal use of infusion therapy. (bvsalud.org)
Patients2
  • The motor fluctuation intensity was only diminished in the 9 patients treated by continuous infusion. (nih.gov)
  • The additional budget required for providing Apomorphine for recent patients (18 cases) and new case (10 cases) was 6.9 million THB per year. (hsri.or.th)
Stimulation1
  • This particular experimental paradigm was chosen in order to complement other work from our laboratory on the responses to continuous, selective D2 stimulation. (baillement.com)
Medication1
  • Infusion-site reactions] are thought to reflect an inflammatory response to infused medication, its metabolites, and/or infusion excipients," Isaacson and colleagues wrote. (neurologylive.com)
Drug1
  • In general, an increased duration of stereotyped behaviour following apomorphine bas been noted, possibly reflecting differences in drug pharmacokinetics. (baillement.com)
Effects2
  • Metoclopramide inhibits the central and peripheral effects of apomorphine, induces release of prolactin and causes a transient increase in circulating aldosterone levels, which may be associated with transient fluid retention. (nih.gov)
  • Relatively few studies have examined the effects of ageing on the behavioural responses to apomorphine in otherwise intact animals. (baillement.com)
Period1
  • Intravenous infusions should be made slowly over a period of not less than 15 minutes, 30 minutes before beginning cancer chemotherapy and repeated every 2 hours for two doses, then every 3 hours for three doses. (pfizermedicalinformation.com)