G20/G21.1
IDIOPATHIC PARKINSON DISEASE
DESCRIPTION
Parkinsonism is a syndrome characterised by tremor, rigidity, bradykinesia and postural disturbances. It may be primary, i.e. Parkinson’s disease, or secondary, i.e. drug-induced, or due to uncommon disorders that may initially resemble Parkinson’s disease.
The objective of treatment is to:
- minimise disabling symptoms
- prevent complications and avoid serious drug-induced side effects
GENERAL MEASURES
General supportive therapy and advice about lifestyle modification, physiotherapy and occupational therapy.
MEDICINE TREATMENT
Note: Set therapeutic targets so that the patient is functioning as well as possible.
Bradykinesia, rigidity and postural disturbance:
- Carbidopa/levodopa, 25/100 mg (1 tablet), oral, 8 hourly, increase gradually according to clinical response.
- Maximum dose of 200/800 mg daily (8 tablets).
- Increase dose in consultation with a specialist.
REFERRAL
- Alternative diagnosis suspected (e.g. Parkinson’s plus disorders etc.)
- No improvement or poor control with treatment.
- Increasing on/off phenomenon.
- Dyskinesias.