PT  - JOURNAL ARTICLE
AU  - Manyam, Bala V.
TI  - Practical Guidelines for Management of Parkinson Disease
AID  - 10.3122/jabfm.10.6.412
DP  - 1997 Nov 01
TA  - The Journal of the American Board of Family
                Practice
PG  - 412--424
VI  - 10
IP  - 6
4099  - http://www.jabfm.org/content/10/6/412.short
4100  - http://www.jabfm.org/content/10/6/412.full
SO  - J Am Board Fam Med1997 Nov 01; 10
AB  - Background: This article describes a specialist's perspective on the challenge of caring for patients with Parkinson disease in a changing American health care environment that places increasing responsibility on primary care physicians. Methods: Guidelines were developed by drawing from a combination of personal experience at a large university Parkinson disease clinic, literature review, presentations at various family practice continuing medical education conferences, and involvement as investigator in various clinical trials of drugs used in Parkinson disease treatment. Results and Conclusions: From a therapeutic standpoint, Parkinson disease can be divided into three stages—early, nonfluctuating, and fluctuating. Although the same drugs, namely, carbidopa-Ievodopa preparations, dopamine agonists, and anticholinergic medications, are usually prescribed, their pattern of use, including frequency and dosing, varies depending on the nature of the dominant symptoms and stage of the disease. Management of Parkinson disease requires familiarity with both the disease-related and drug-related components. Optimal functional efficiency for the patient is gained through striking a delicate balance between the drug regimen and the disease-related components.