R. Piudo - Academia.edu (original) (raw)
Papers by R. Piudo
Medicine - Programa de Formaci?n M?dica Continuada Acreditado, 2007
ABSTRACT Undoubtedly, one of the fields of neurology undergoing continuous changes is that of ata... more ABSTRACT Undoubtedly, one of the fields of neurology undergoing continuous changes is that of ataxia syndromes, especially in terms of hereditary autosomal dominant neurodegenerative syndromes. At least 30 of these syndromes linked to disorders in the various gene loci have been described. This chapter describes the semiological aspects and classification of ataxia syndromes and, more specifically and extensively, the etiological, neuropathological, diagnostic and therapeutic aspects of the most common types of heredodegenerative, degenerative and acquired ataxia.
Neurología, 2014
Non-ergoline dopamine agonists (DA) are effective treatments for Parkinson's disease (PD)... more Non-ergoline dopamine agonists (DA) are effective treatments for Parkinson's disease (PD). This review presents the pharmacology, evidence of efficacy and safety profile of pramipexole, ropinirole, and rotigotine, and practical recommendations are given regarding their use in clinical practice. Extended-release formulations of pramipexole and ropinirole and transdermal continuous delivery rotigotine patches are currently available; these may contribute to stabilising of plasma levels. In early PD, the three drugs significantly improve disability scales, delay time to dyskinesia and allow a later introduction of levodopa. In late PD they reduced total 'off'-time, improved Unified Parkinson's Disease Rating Scale (UPDRS) in both 'on' and 'off' state and allowed a reduction in total levodopa dosage. A significant improvement in quality of life scales has also been demonstrated. Extended-release formulations have proved to be non-inferior to the immediate release formulations and are better tolerated (ropinirole). Despite a generally good safety profile, serious adverse events, such as impulse control disorder and sleep attacks, need to be routinely monitored. Although combination therapy has not been addressed in scientific literature, certain combinations, such as apomorphine and another DA, may be helpful. Switching from one DA to another is feasible and safe, although in the first days an overlap of dopaminergic side effects may occur. When treatment with DA is stopped abruptly, dopamine withdrawal syndrome may present. Suspending any DA, especially pramipexole, has been linked to onset of apathy, which may be severe. New non-ergotine DAs are a valuable option for the treatment of both early and late PD. Despite their good safety profile, serious adverse effects may appear; these effects may have a pathoplastic effect on the course of PD and need to be monitored.
Medicine - Programa de Formaci?n M?dica Continuada Acreditado, 2007
ABSTRACT Undoubtedly, one of the fields of neurology undergoing continuous changes is that of ata... more ABSTRACT Undoubtedly, one of the fields of neurology undergoing continuous changes is that of ataxia syndromes, especially in terms of hereditary autosomal dominant neurodegenerative syndromes. At least 30 of these syndromes linked to disorders in the various gene loci have been described. This chapter describes the semiological aspects and classification of ataxia syndromes and, more specifically and extensively, the etiological, neuropathological, diagnostic and therapeutic aspects of the most common types of heredodegenerative, degenerative and acquired ataxia.
Neurología, 2014
Non-ergoline dopamine agonists (DA) are effective treatments for Parkinson's disease (PD)... more Non-ergoline dopamine agonists (DA) are effective treatments for Parkinson's disease (PD). This review presents the pharmacology, evidence of efficacy and safety profile of pramipexole, ropinirole, and rotigotine, and practical recommendations are given regarding their use in clinical practice. Extended-release formulations of pramipexole and ropinirole and transdermal continuous delivery rotigotine patches are currently available; these may contribute to stabilising of plasma levels. In early PD, the three drugs significantly improve disability scales, delay time to dyskinesia and allow a later introduction of levodopa. In late PD they reduced total 'off'-time, improved Unified Parkinson's Disease Rating Scale (UPDRS) in both 'on' and 'off' state and allowed a reduction in total levodopa dosage. A significant improvement in quality of life scales has also been demonstrated. Extended-release formulations have proved to be non-inferior to the immediate release formulations and are better tolerated (ropinirole). Despite a generally good safety profile, serious adverse events, such as impulse control disorder and sleep attacks, need to be routinely monitored. Although combination therapy has not been addressed in scientific literature, certain combinations, such as apomorphine and another DA, may be helpful. Switching from one DA to another is feasible and safe, although in the first days an overlap of dopaminergic side effects may occur. When treatment with DA is stopped abruptly, dopamine withdrawal syndrome may present. Suspending any DA, especially pramipexole, has been linked to onset of apathy, which may be severe. New non-ergotine DAs are a valuable option for the treatment of both early and late PD. Despite their good safety profile, serious adverse effects may appear; these effects may have a pathoplastic effect on the course of PD and need to be monitored.