Drugs Blog

How the Drug Works:

Parkinsonism is a neurological disease with a variety of origins characterized by tremor, rigidity, and disorders of posture and equilibrium. The onset is slow and progressive with symptoms advancing over months to years.

The group of drugs known as “anticholinergic agents” can reduce the frequency and severity of the symptoms of parkinsonism by restoring the chemical imbalance that causes Parkinson disease. The effectiveness of anticholinergics for parkinsonism is not dependent on the origin of the symptoms. These agents are typically used for milder cases of parkinsonism.

Uses:

To reduce the frequency and severity of the symptoms of parkinsonism and to control drug-induced parkinsonism-like disorders. Used alone or with other anti parkinson agents. Anticholineric agents do not cure the causes of these symptoms.

Precautions:

Pregnancy: Adequate studies have not been done in pregnant women. Use only if clearly needed and potential benefits outweigh the possible hazards to the fetus.

Breastfeeding: Anticholinergic agents appear in breast milk and may reduce milk production. Consult your doctor before you begin breastfeeding.

Children: Do not use benztropine in children younger than 3 years old. Safety and effectiveness in older children have not been established.

Elderly: Geriatric patients, particularly over 60, frequently develop increased sensitivity to anticholinergic drugs and require strict dosage monitoring. Use with caution. Mental confusion and disorientation, agitation, hallucinations and psychotic-like symptoms may develop. Administer carefully to elderly patients with hardening of the arteries because side effects may be more severe.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary supplements with anticholinergic agents. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with anticholinergic agents.

• Antihistamines (eg, diphenhydramine)
• Chlorpromazine (eg, horazine)
• Digoxin (eg, anoxin)
• Haloperidol (eg, haldol)
• Levodopa (eg, larodopa)
• Narcotic pain relievers (eg, percodan)
• Tricyclic antidepressants (eg, amitriptyline)

Side Effects:

Every drug is capable of producing side effects. Many anticholinergic users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy and individual susceptibility. Possible side effects include:

Possible Side Effects Specific to Ethopropazine: Seizures; brain wave changes, blood disorders; hormone disorders; yellow discoloration of skin and eyes (jaundice); and hallucinations.

Digestive Tract: Nausea; vomiting; stomach pain; constipation.

Nervous System: Disorientation; confusion; memory loss; hallucinations; lightheadedness; dizziness; weakness; agitation; nervousness; paranoia; delusions; delirium; excessive elation; excitement; depression.

Circulatory System: Rapid heart rate; pounding of chest (palpitations); low blood pressure; lightheadedness and dizziness upon rising quickly from a lying position.

Skin: Rash; flushing; decreased sweating; hives.

Eyes or Ocular: Blurred vision; double vision; widened pupils; visual disturbances; glaucoma.

Other: Difficulty urinating; painful urination; muscle weakness; cramping; dry mouth; fever; numbness of fingers; difficulty achieving or maintaining erection; blood disorders (orphenadrine citrate); swollen glands.

Guidelines for Use:

• May cause drowsiness, dizziness, or blurred vision. Use caution when driving or performing other tasks requiring alertness.
• Avoid alcohol and other drugs that cause drowsiness when using anticholinergic agents.
• Stomach upset may occur. Take with food.
• Sucking on hard candy, drinking fluids, or maintaining good dental hygiene can relieve the dry mouth that can result from taking any of the anticholinergic agents.
• Difficult urination and constipation can occur. Use “stool softeners” if necessary. Notify your doctor if either difficult urination or constipation persist.
• Notify your doctor if a rapid heartbeat, pounding sensation in chest, confusion, eye pain, or rash occurs.
• Anticholinergic agents can reduce the ability to sweat, an important function by which overheating is prevented. Avoid excess sun or exercise which may cause excessive sweating.
• Elderly patients may be highly sensitive to anticholinergic drugs. Use with caution. See Precautions.

Type of Drug:

Antiparkinson agent.

How the Drug Works:

Parkinsonism is a neurological disease characterized by tremor, rigidity, and disorders of posture and equilibrium. It has multiple causes. The onset is slow and progressive with symptoms advancing over months to years.

It is thought that the involuntary muscle movements (shaking) of Parkinson disease are due to reduced amounts of the chemical dopamine in the central nervous system (brain). Pergolide may exert its effects by directly stimulating the dopamine receptors in the brain.

Uses:

To manage the signs and symptoms of Parkinson’s disease. Used along with levodopa and carbidopa.

For complete information on levodopa and carbidopa as antiparkinson agents, see the Antiparkinson-Dopaminergic

Precautions:

Neuroleptic Malignant-like Syndrome (NMS): NMS, including muscular rigidity, elevated body temperature, mental changes, and increased serum enzymes, has been reported when anti parkinson agents were stopped suddenly. Therefore, do not reduce the dosage of pergolide abruptly or discontinue it without consulting your doctor.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if clearly needed.

Breastfeeding: It is not known if pergolide appears in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness have not been established.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take Any OVOI the-counter or prescription medications or dietary supplements with pergolide mesylate. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drug and drug classes interact with pergolide mesylate:

• Butyrophenones (eg, haloperidol)
• Metoclopramide (eg, Reglan)
• Phenothiazines (eg, chlorpromazine)
• Thioxanthines (eg, thiothixene)

Side Effects:

Every drug is capable of producing side effects. Many pergolide users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Nausea; vomiting; constipation; diarrhea; indigestion; stomach pain; appetite loss; difficulty swallowing.

Nervous System: Hallucinations; difficult or abnormal movement; restlessness; twitching; confusion; dizziness; drowsiness; fainting; sleeplessness; anxiety; tremor; depression; abnormal dreams; personality changes; headache; weakness; incoordination; difficulty walking.

Circulatory System: High or low blood pressure; orthostatic hypotension (dizziness or lightheadedness when arising from a seated or lying position); palpitations (pounding in the chest); irregular heartbeat; heart attack.

Respiratory System: Runny nose; difficulty breathing.

Skin: Rash; sweating; abnormal skin sensations.

Other: Dry mouth; taste changes; general body pain; joint, muscle, or nerve pain; abnormal vision; double vision; frequent urination; urinary tract infections; blood in urine; edema (fluid retention); back, neck, and chest pain; flu-like symptoms; nosebleed; hiccups; weight gain; chills; difficulty speaking; anemia.

Guidelines for Use:

• Dosage will be individualized.
• Do not change the dose or stop taking this medicine unless advised to do so by your doctor.
• If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless advised by your doctor. If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
• Notify your doctor if you experience confusion, hallucinations, pounding in the chest, irregular heart rate, or difficulty in movement.
• Orthostatic hypotension – Dizziness or lightheadedness may occur when arising quickly from a seated or lying position. Avoid sudden changes in posture while taking pergolide.
• May cause drowsiness. Use caution while driving or performing other tasks requiring alertness, coordination, or physical dexterity.
• Inform your doctor if you are pregnant, become pregnant, are planning to become pregnant, or if you are breastfeeding.
• Store at controlled room temperature (59 to 86°F).