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On‐off phenomenon: Relation to levodopa pharmacokinetics and pharmacodynamics
Abstract
Motor function in the moderately to severely affected parkinsonian patient is critically dependent upon delivery of levodopa to the striatum. This, in turn, is influenced by the fluctuating plasma concentrations of levodopa produced by the drug's short half‐life and erratic absorption, and by modifiable transport at the blood‐brain barrier. Duration of response to a single dose of levodopa is proportional to peak plasma drug levels, and paradoxical responses may occur when plasma concentrations are in the vicinity of minimum effective concentrations. Thus the strategy of administering frequent, small doses of levodopa may contribute additional unpredictability to a fluctuating clinical response imposed by pharmacokinetic factors.
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Citations
Cited by
Ahlskog, J. E., & Muenter, M. D. (2001) · Movement Disorders · doi:10.1002/mds.1090 · Cited by 1,454
Levodopa in the treatment of Parkinson's disease
Schapira, A. H. V., Emre, M., Jenner, P., & Poewe, W. (2009) · European Journal of Neurology · doi:10.1111/j.1468-1331.2009.02697.x · Cited by 231
Christine, C. W., Bankiewicz, K. S., Van Laar, A. D., Richardson, R. M., Ravina, B., Kells, A. P., Boot, B., Martin, A. J., Nutt, J., Thompson, M. E., et al. (2019) · Annals of Neurology · doi:10.1002/ana.25450 · Cited by 167
Self-citationThe influence of levodopa on gastric emptying in healthy elderly volunteers
Robertson, D. R. C., Renwick, A. G., Macklin, B., Jones, S., Waller, D. G., George, C. F., & Fleming, J. S. (1992) · European Journal of Clinical Pharmacology · doi:10.1007/bf00280127 · Cited by 45
Metadata
- Authors
- Nutt, J. G.
- Venue
- Annals of Neurology
- Publisher
- Wiley
- Published
- 1987-10
- Volume
- 22
- Issue
- 4
- Pages
- 535-540
- ISSN
- 0364-5134 (ISSN-L)
- 1531-8249
- OpenAlex
- W2085965461
- Cited by
- 159
- References
- 0
- FWCI
- 6.77
- Type
- journal article
- Language
- en
- Open access
- closed
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- Nutt, J. G. (1987). On‐off phenomenon: Relation to levodopa pharmacokinetics and pharmacodynamics. Annals of Neurology. https://doi.org/10.1002/ana.410220415
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