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Monday, October 19, 2009


Salam. “WELL DONE” e2lh kt2 dr lec nureen. bkn mdh nk dpt pujian dr mdm. Bkn mdh nk bt mdm sk. And, I make her like my speech which title, “Drug Therapy: Medication for Parkinson’s disease”. Spjg bt “kajian” ttg tjuk ni, nureen rs mcm ambl kos farmasi je. Mn xnyer nureen pnya rujukn 10 rujukan. Penat gak nk bc sume2 2. Tmbh2 lg byk perkataan sains dignkn. Most of my classmates pn tkjt dgn tjuk speech nureen cz nureen berani plh tjuk 2.huhu. tp, ia sgt b’baloi..=). Di sini nureen sertakan speech yg tlh nureen present.



Mdm. Hjh Begum binti Ibrahim & my fellow classmates. Assalammualaikum w.b.t and a very good morning.

Muhammad Ali. By looking at his picture and listening his name, I’m sure all of you know him. Muhammad Ali is the most recognizable face in the world. Muhammad Ali, who was a championship boxer, was considered as one of the best fighters of all time. Unfortunately, as he plain for the entire world to see, Muhammad Ali is sick. He can barely speak; he can barely walk without assistance; his hands tremble and shake. It’s almost painful to juxtapose Muhammad Ali’s current state with that of his “float like a butterfly, sting like a bee”. Guess, what was happening to this man. He has Parkinson’s syndrome, a neurological condition that affects motor and speech control.

According to the book Understanding Parkinson’s disease by Richard Rosenbaum, Kampavata which in Sanskrit means “tremor and lack of muscular movement” is another name for Parkinson’s disease. The symptoms of kampavata are slow movement, drooling, reptilians stare, tremor, constant somnolence, rigidity and dementia. The question is, do Parkinson’s disease can be cure? How it will be cure? Today, I’m standing here to answer your questions. I’m here because I want to share with you about the medication for Parkinson’s disease using drugs therapies which are levodopa, dopamine agonist and enzyme inhibitors. Let’s start with levodopa first.


As define by neurology health and cares, one of the drugs that use in the medication of Parkinson is levodopa (L-dopa). Levodopa which replaces the dopamine is the single most effective treatment for the symptoms of Parkinson’s disease. It is a building block in the process that brain cells use to manufacture dopamine. L-dopa therapy usually remains effective for five years or longer. Levodopa is so effective that some people may forget they have Parkinson’s. But levodopa is not a cure. According to George Cotzias, dopamine in the blood does not get into the brain. The levodopa must be use with carbidopa. Carbidopa does not enter the brain, blocks the enzyme that converts levodopa into dopamine in other parts of the body. By restricting the release of dopamine in the stomach, carbidopa greatly decrease the unpleasant side effects associated with levodopa alone.

Everything has pro and contra. Although L-dopa is so effective, it comes with side effects. Nausea and vomiting appear when the dose of carbidopa is not large enough to control these side effects. Nausea and vomiting effects can be reducing by taking drug with a light meal or snack. Meanwhile, involuntary movements (dyskinesias) such as tics, twisting and restlessness effect can only are controlled by lowering the dose of levodopa or, doing the surgery in some cases.


Besides using levodopa as a drug theraphy, there is other way to cure the Parkinson’s disease which is dopamine agonists. Dopamine agonists is the chemicals that mimic the role of dopamine in the brain are commonly used alone to treat early Parkinson’s disease or using together with levodopa to treat advanced Parkinson’s disease. This kind of treatment imitates the action of dopamine in the brain and cause nerve cells to react as if dopamine were present.

There are four types’ dopamine agonists that are available in the medication of Parkinson’s disease. The four dopamine agonists are Pramipexole, Ropinirole, Bromocriptine, and also Pergolide. Pramipexole and Ropinirole are non-ergot dopamine agonists meanwhile Bromocriptine and pergolide are ergot-derived dopamine agonists.
Pramipexole and Ropinirole may be used as a “first-line” treatment, as a main treatment, particularly for people with young onset. At first, patients will fall asleep while driving and it can produce daytime sleepiness when taking one of these drugs. Meanwhile, Bromocriptine and pergolide can cause fibrotic changes in the lungs after prolonged use but these symptoms are reversible if the drug is stopped. Besides, it also can cause a condition in the lower legs that makes Parkinson’s patients red, hot and painful.


Now we already know two types of drug that can help in the medication of Parkinson’s disease. I’m sure you are wondering what is the last drug that been using in medication of Parkinson’s disease. There are two types of enzymes inhibitor which are monoamine oxidase B (MAO-B) inhibitor and catechol-O methyltransferase (COMT). This 2 enzymes are compounds that impair the breakdown of dopamine and thus increase the amount of dopamine that is available to neurons. The MAO-B inhibitors, such as selegiline and rasagiline, prevent the enzyme MAO-B from breaking down dopamine in the brain itself. Selegiline may delay the need for stronger drugs, possibly by exerting a mild counter effect or by protecting neurons from damage. Rasagiline is a newer medication that is more selective, more potent, and has less action outside the brain, thus decreased peripheral side effects.

The COMT is blocked or inhibited, for example, more levodopa can reach the brain’s motor control system. The COMT inhibitor particularly helpful for people with motor fluctuations. COMT inhibitors increase the amount of levodopa entering the brain and prolong its effects. Entacapone (brand name Stalevo) is a new dopamine replacement therapy that combines the COMT inhibitor with carbidopa/levodopa. Another COMT inhibitor, tolcapone (brand name Tasmar), is available but has been associated with serious liver damage in some persons.


To sum up my speech today, Parkinson’s disease is a neurological condition that gets worse over time. Although there are several ways to cure the disease, such as drug therapy and surgical techniques, it will give the Parkinson’s patient a numbers of side effects. According to World Health Organization (WHO), research is continuing into the use of fetal brain tissue implants, but as yet the results are inconclusive. But, the Parkinson’s patient must always remains optimistic and do not blame to the God for what had happened to them.


Richard B. Rosenbaum (2006). Understanding Parkinson’s disease: A Personal and Professional View.
Punit Agrawal, “Understanding Parkinson’s Disease Medication”, NetWellness. December Newspaper
Anthony Thanasayan, “Positive Outlook”, The Star. September 17, 2009.
11, 2006.
Internet Sources “Dopamine Medications for Parkinson’s Disease” by Patrick Mc.Namara, Pd. D. (May 14, 2009) Retrieved October 5, 2009 from
Associated Content. “Muhammad Ali's Battle against Parkinson's syndrome: Is Boxing To Blame?” by Jason Medina. (November 06, 2007) Retrieved October 5, 2009 from
Harward Special Health Reports. “Medications for Parkinson’s Disease” Retrieved October 5, 2009 from
Health Medication. “Medications Used to Treat Parkinson’s disease” Retrieved October 5,
2009 from
Neurology Health and Cares. “What Medications are Available to Cure Parkinson’s Disease” Retrieved October 5, 2009 from
Spring 2008. “Medications for Parkinson’s Disease: What’s on the Horizon?” By David B. Sommer, M.D., M.P.H., and Mark A. Stacy, M.D. Retrieved October 5, 2009 from
World Health Organization. “Parkinson’s Disease – A Unique Survey Launched” (October 14, 1998) Retrieved October 5, 2009 from


1 comment:

Muhammad Shahir Salleh said...

it seems 2 b agreat speech...=)


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