Parkinson's disease is a chronic progressive extrapyramidal degenerative disease. The main clinical manifestations are muscle tonus, decreased movement, postural instability, and resting tremor; severe patients are also accompanied by memory impairment and dementia.

Clinically, levodopa is commonly used as a dopamine analog, about 95% of the drug is decarboxylated into dopamine in the periphery after absorption, and only 1% enters the brain through the blood-brain barrier. In order to reduce its adverse effects and enhance its efficacy, levodopa and its peripheral decarboxylase inhibitors (benserazide, carbidopa) are now mostly used to make a compound preparation according to 4:1, which reduces the dosage of levodopa by 3/4 [1]. This drug is more effective in mild and young patients and less effective in severe or old and weak patients. Gastrointestinal reactions such as nausea, vomiting, and anorexia occur in about 80% of patients if the drug is used alone; in addition, upright hypotension, cardiac arrhythmia, and involuntary movements may occur.

Antiacetylcholine drug, Benzhexol: It is mainly used in patients with mild disease or intolerance of levodopa, often combined with levodopa. This drug should be taken after meals, can reduce gastrointestinal irritation, for glaucoma, prostate hypertrophy patients are prohibited.

Peripheral decarboxylase inhibitor, carbidopa: applicable to various causes of Parkinson's disease, often combined with levodopa, such as the patient has been used levodopa, must be discontinued for more than 8h before the two drugs can be used in combination if necessary, can be added to the vitamin B6. similar drugs are also benserazide.

Monoamine oxidase inhibitor, selegiline: selegiline enhances the efficacy of levodopa and should be used in combination to reduce the dose of levodopa, especially for high-dose levodopa therapy producing on-off and other movement disorders.

Catecholamine oxygen-site methyltransferase inhibitor, entacapone: use in Parkinson's disease overdose can cause convulsions and diminished movement.

bibliography

[1] YE Ying-An,RUAN Zhi-Fang. Rational application of levodopa in the treatment of Parkinson's disease[J]. Chinese Journal of Practical Neurological Diseases,2008(01):101-103.

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