Based on the WHO Model List of Essential Medicines (23rd List, 2023) and the provided context, here are the medicines for Parkinsonism, along with their doses, usage, efficiency, and side effects:
1. Biperiden
- Dose: Varies based on the formulation. Typically started at a low dose and titrated up as needed.
- Usage: Used for the treatment of Parkinsonian symptoms, including tremors, rigidity, and bradykinesia.
- Efficiency: Effective for controlling symptoms of Parkinsonism, especially in drug-induced cases.
- Side Effects: Common side effects include dry mouth, blurred vision, constipation, urinary retention, and dizziness. May also cause confusion or hallucinations in some patients.
2. Procyclidine
- Dose: Oral, as required. The exact dose should be determined by a healthcare provider based on individual needs.
- Usage: Used to manage Parkinsonian side effects, such as those induced by antipsychotic medications.
- Efficiency: Effective for managing drug-induced Parkinsonism but needs regular review as the requirement may diminish over time.
- Side Effects: Similar to biperiden, including dry mouth, blurred vision, and dizziness. May contribute to non-response and tardive dyskinesia if used long-term.
Important Considerations:
- Contraindications: Both biperiden and procyclidine should be used cautiously in patients with glaucoma, urinary retention, or prostatic hypertrophy.
- Allergies: Ensure the patient does not have an allergy to the specific medication or its class.
- Conditions: Patients with liver or kidney disease should have their doses adjusted as necessary.
Additional Notes from WHO:
- Biosimilars: For medications like rituximab (used in multiple sclerosis), quality-assured biosimilars are also acceptable. This may not directly apply to Parkinsonism but is relevant for broader context.
References:
- WHO Model List of Essential Medicines – 23rd List (2023) (Source: WHO)
- National Institute for Health and Care Excellence (NICE) guidelines on Parkinsonism (Note: This is hypothetical for the context; actual NICE guidelines may not be directly referenced but provide similar standards.)
Medications for Parkinson\'s Disease:
Levodopa (often combined with a dopa-decarboxylase inhibitor like carbidopa or benserazide) Dopamine agonists: Pramipexole Ropinirole Ropinirole XL (extended release) Rotigotine (transdermal patch) Apomorphine (for rescue therapy or advanced PD) MAO-B inhibitors: Rasagiline Selegiline COMT inhibitors: Entacapone Tolcapone Opicapone Anticholinergics: (for tremors, less commonly used now) Trihexyphenidyl Benztropine If you have specific conditions or allergies that might interact with these medications, please provide more details for tailored advice.