Duodenal and gastric delivery of levodopa in parkinsonism.

Abstract:

:To clarify the influence of gastric emptying on levodopa-related motor fluctuations in Parkinson's disease, we assessed mobility and plasma levodopa concentrations in 10 patients during five modes of levodopa administration: (1) standard intermittent oral (SIO), (2) intermittent duodenal (ID), (3) continuous duodenal infusion (CDI), (4) continuous gastric infusion (CGI), and (5) controlled-release Sinemet (CR-4). The rank order from greatest to least for both percentage of time "on" and average mobility score was CDI, CGI, ID, CR-4, and SIO. The rank order for variance of means, a measure of fluctuation, from least to greatest for mobility was CDI, CGI, CR-4, ID, SIO, and for plasma levodopa concentrations was CDI, CGI, ID, SIO, and CR-4. The results demonstrate that it is possible to produce very steady plasma concentrations of levodopa with a corresponding reduction in motor fluctuations by continuous intraduodenal administration of the drug. This mode of delivery is an ideal model for the development of optimal continuous-release preparations of levodopa. Other enteral routes have produced a more variable plasma levodopa concentration and clinical response.

journal_name

Ann Neurol

journal_title

Annals of neurology

authors

Kurlan R,Nutt JG,Woodward WR,Rothfield K,Lichter D,Miller C,Carter JH,Shoulson I

doi

10.1002/ana.410230611

subject

Has Abstract

pub_date

1988-06-01 00:00:00

pages

589-95

issue

6

eissn

0364-5134

issn

1531-8249

journal_volume

23

pub_type

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