Treatment for Parkinson’s Disease 帕金森氏病治疗
At this time, there is no treatment that arrests the neuron degeneration of Parkinson’s disease and the eventual decline in patient function. Surgical procedures involving the basal ganglia have been tried with varying success at prolonging the degeneration caused by this disease. Drug therapy remains the primary treatment.
目前没有治疗可以抑制帕金森氏病的神经元退化和患者功能的最终下降。基底核手术在延长疾病引起的退化进程方面，其成功程度也多种多样。药物疗法仍是评分的治疗途径。
Therapy is aimed at restoring the balance between the declining levels of dopamine, which has an inhibitory effect on the neurons in the basal ganglia, and the now-dominant cholinergic neurons, which are excitatory.
治疗旨在恢复多巴胺水平下降与现在处于主导地位的胆碱能神经元之间的平衡，前者对基底核具有抑制效应，后者则是兴奋性的。
This may help to reduce the signs and symptoms of parkinsonism and restore normal function for a time.
这可能有助于减少帕金森综合征症状体征，一定时间恢复正常功能。
● FIGURE Drug therapy in treating Parkinson’s disease is aimed at achieving a balance between the stimulating cholinergic effects and the inhibitory effects of dopamine in the basal ganglia. Type 1 drugs affect dopamine and are inhibitory. Type 2 drugs block cholinergic effects, preventing stimulation.
图 帕金森氏病药物疗法旨在获得胆碱能兴奋效应与基底核多巴胺抑制效应之间的平衡。1类药物影响多巴胺，为抑制性；2类药物阻断胆碱能效应，预防兴奋。
Total management of patient care in individuals with Parkinson’s disease presents a challenge. Patients should be encouraged to be as active as possible, to perform exercises to prevent the development of skeletal deformities, and to attend to their care as long as they can. Both the patient and family need instruction about following drug protocols and monitoring adverse effects, as well as encouragement and support for coping with the progressive nature of the disease (Box 24.1). Because of the degenerative effects of this disease, patients may experience episodes of depression or emotional upset. Psychological support, as well as physical support, is a crucial aspect of care.
帕金森氏病个体的总体病人医疗管理是一大挑战。应鼓励患者尽量保持积极主动，通过锻炼防止骨骼畸形的发展，尽量参与医疗。患者和家人都需要通过教育了解下列药物治疗方案、监测不良效应、及为应对疾病的进行性特征提供鼓励和支持（表框24.1）。鉴于该疾病的退行性效应，患者可能经历抑郁或情感失常发作。因此，心理支持及躯体支持是医疗的关键内容之一。
★Vocabulary for Today ★
arrest – v. 阻止，停搏
degeneration – n. 退化，堕落，衰退
basal ganglia – n. 基底核，基底神经节
prolong – v. 延长，拖延
dopamine – n. 多巴胺
dominant – a. 占主导的，优势的
cholinergic – a. n. 胆碱功能的，胆碱能药
excitatory – a. 兴奋性的
inhibitory – a. 抑制性的
deformity – n. 畸形，残缺
attend – v. 注意，照料，护理
1. A nurse notes that a client with schizophrenia and receiving an antipsychotic medication is having uncontrolled movement of the lips and tongue. The nurse determines that the client is experiencing?
A. Hypertensive crisis.
B. Parkinsonism.
C. Tardive dyskinesia.
D. Neuroleptic malignant syndrome.
2. Before administering amantadine (Symadine), the nurse should investigate which of the following client statements?
A. “My hands are always shaking.”
B. “I had to take Dilantin 6 months ago.”
C. “I take low-dose enteric aspirin each day.”
D. “Simple tasks seem to take so long to perform.”
奥医教育“在线自测”正式上线，复习练习、效果检验，奥医NCLEX-RN/ISPN题库一站完成。
答案 Answers 1. C. Tardive dyskinesia. Rationale: Tardive dyskinesia is characterized by uncontrollable involuntary movements of the body and extremities (especially of the face, lips, mouth, tongue, arms or legs). Option A, Hypertensive crisis occurs from the use of MAOIs. Option B, Parkinsonism is characterize by tremor, slow movement, impaired speech or muscle stiffness. Option D, Neuroleptic malignant syndrome is a life-threatening condition caused by an adverse reaction to antipsychotic drugs. Symptoms include high fever, sweating, unstable blood pressure, stupor, muscular rigidity, and autonomic dysfunction. 2. B. “I had to take Dilantin 6 months ago.” Rationale: Amantadine is used cautiously in clients with a history of seizures. A and D are clinical manifestations of Parkinson’s disease. Amantadine does not interact negatively with aspirin.
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