RESUMO
In this Danish-Norwegian randomized double-blind parallel-group multicentre study, we compared the therapeutic response of slow-release Madopar HBS to standard Madopar in 134 de novo patients with idiopathic Parkinson's disease during a 5-year period. The drugs were dosed according to the individual need of the patients. The Webster, NUDS, UPDRS and Hoehn & Yahr scales were used for evaluation of symptoms. Addition of a morning dose of standard Madopar 62.5 mg was allowed after 6 months. Bromocriptine could be administered but not Selegiline. Sixty-five patients got Madopar HBS and 69 standard Madopar. Surprisingly, no differences were found as to the mean daily levodopa dose, the mean number of daily doses or the use of the doses of bromocriptine. Unexpectedly, we found a trend towards a more frequent use of a morning dose of standard Madopar in the group treated with the standard formulation. No differences were observed in the occurrence of motor fluctuations or dyskinesia, the incidence of which was relatively low. Sustained-release Madopar (HBS) thus proved to be as effective as standard Madopar in the long-term treatment of de novo parkinsonian patients, but the drug showed no advantage in postponing or reducing the long-term levodopa treatment problems.
Assuntos
Antiparkinsonianos/administração & dosagem , Benserazida/administração & dosagem , Levodopa/administração & dosagem , Doença de Parkinson/tratamento farmacológico , Idoso , Antiparkinsonianos/efeitos adversos , Benserazida/efeitos adversos , Preparações de Ação Retardada , Dinamarca , Relação Dose-Resposta a Droga , Método Duplo-Cego , Esquema de Medicação , Combinação de Medicamentos , Feminino , Humanos , Levodopa/efeitos adversos , Masculino , Pessoa de Meia-Idade , Exame Neurológico/efeitos dos fármacos , Noruega , Doença de Parkinson/diagnósticoRESUMO
An open study with iohexol (Omnipaque) in cervical myelography has been performed in 20 patients to evaluate the properties and neurotoxicity of this new water soluble contrast medium. The image quality was good (30%) or excellent (70%) in all cases. The frequency of headache was 25%. No EEG changes were severe and the total frequency was 20%. We conclude that this study supports other reports of iohexol having a low neurotoxicity and is well suited for intrathecal use.
Assuntos
Iodobenzoatos , Mielografia , Ácidos Tri-Iodobenzoicos , Adulto , Idoso , Meios de Contraste , Avaliação de Medicamentos , Eletroencefalografia , Feminino , Cefaleia/induzido quimicamente , Humanos , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Iohexol , Masculino , Pessoa de Meia-Idade , Mielografia/métodos , Náusea/induzido quimicamente , Doenças da Medula Espinal/diagnóstico por imagem , Estenose Espinal/diagnóstico por imagem , Ácidos Tri-Iodobenzoicos/efeitos adversosRESUMO
A randomized double blind study with iohexol (Omnipaque) and metrizamide (Amipaque) in cervical myelography was performed in 50 patients, 29 with iohexol and 21 with metrizamide. The myelographies were performed either with lumbar or with C1-C2 puncture in about equal groups, using 300 mg I/ml and 240 mg I/ml of the contrast media respectively. The image quality was equal with both contrast media, excellent in about 4/5 and good in 1/5 of the examinations. Subjective side effects were twice as frequent with metrizamide as with iohexol. The most frequent side effect was headache, occurring in 34% with iohexol and in 67% with metrizamide. Altogether 24% or the patients had EEG changes after iohexol as compared to 47% after metrizamide. All EEG changes were slight dysrythmia-except in three patients with spike activity after metrizamide. These were the only ones with mental reactions as well. It can be concluded that in this trial iohexol was better suited for cervical myelography than metrizamide.
