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Abordagens terapêuticas na doença de Parkinson: intervenção do farmacêutico
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A doença de Parkinson (DP) é uma patologia neurodegenerativa, de origem idiopática que afeta o sistema nervoso central, conduzindo a uma deficiência do neurotransmissor dopamina e a uma deposição/acumulação da proteína ɑ-sinucleína no tecido nervoso. Trata-se de uma doença de progressão lenta, que se pode manifestar através de sintomas motores (bradicinesia, rigidez, tremor de repouso, instabilidade postural) e não motores (depressão, distúrbios do sono, incontinência). O número de casos de parkinsonismo tem vindo a aumentar significativamente ao longo dos anos, sobretudo nos países mais desenvolvidos. A sua epidemiologia varia consoante a localização geográfica, sendo que na Europa estima-se que o número de casos esteja entre os 257 a 1400 doentes por 100 mil habitantes. A presente dissertação tem como objetivos caracterizar a DP, a sua fisiopatologia e epidemiologia, identificar as especificidades dos fármacos utilizados nesta patologia, explorar superficialmente as abordagens não farmacológicas e entender de que forma é que o farmacêutico pode intervir nestes casos, contribuindo para um aumento da qualidade de vida dos doentes. Nos indivíduos diagnosticados com DP, a abordagem terapêutica baseia-se essencialmente na reposição farmacológica dos níveis de dopamina ou na estimulação direta dos recetores dopaminérgicos. No entanto, o uso prolongado destes fármacos tende a perder eficácia. Em fases mais avançadas da doença, as opções terapêuticas eficazes são limitadas e, até ao momento, não existe tratamento capaz de impedir ou retardar o processo neurodegenerativo. Assim, a intervenção do farmacêutico na terapêutica da DP assume uma enorme importância, de forma a garantir que o plano terapêutico está a ser cumprido, avaliando a adesão à terapêutica e a eficácia do tratamento.
Parkinson’s disease (PD) is a neurodegenerative disorder of idiopathic origin that affects the central nervous system, leading to a deficiency of the neurotransmitter dopamine and the deposition/accumulation of the protein α-synuclein in nervous tissue. It is a slowly progressive disease that may manifest through motor symptoms (bradykinesia, rigidity, resting tremor, postural instability) and non-motor symptoms (depression, sleep disturbances, incontinence). The number of parkinsonism cases has been increasing significantly over the years, especially in more developed countries. Its epidemiology varies according to geographical location, with estimates in Europe ranging from 257 to 1,400 patients per 100,000 inhabitants. The present dissertation aims to characterize PD, its pathophysiology and epidemiology, identify the specificities of the drugs used in this condition, briefly explore non-pharmacological approaches, and understand how the pharmacist can intervene in these cases, contributing to an improved quality of life for patients. In individuals diagnosed with PD, the therapeutic approach is essentially based on pharmacological replacement of dopamine levels or direct stimulation of dopaminergic receptors. However, prolonged use of these drugs tends to lose effectiveness. In more advanced stages of the disease, effective therapeutic options are limited, and, to date, there is no treatment capable of preventing or delaying the neurodegenerative process. Thus, the pharmacist’s intervention in the therapy of PD plays a crucial role in ensuring that the therapeutic plan is being followed, while also assessing treatment adherence and effectiveness.
Parkinson’s disease (PD) is a neurodegenerative disorder of idiopathic origin that affects the central nervous system, leading to a deficiency of the neurotransmitter dopamine and the deposition/accumulation of the protein α-synuclein in nervous tissue. It is a slowly progressive disease that may manifest through motor symptoms (bradykinesia, rigidity, resting tremor, postural instability) and non-motor symptoms (depression, sleep disturbances, incontinence). The number of parkinsonism cases has been increasing significantly over the years, especially in more developed countries. Its epidemiology varies according to geographical location, with estimates in Europe ranging from 257 to 1,400 patients per 100,000 inhabitants. The present dissertation aims to characterize PD, its pathophysiology and epidemiology, identify the specificities of the drugs used in this condition, briefly explore non-pharmacological approaches, and understand how the pharmacist can intervene in these cases, contributing to an improved quality of life for patients. In individuals diagnosed with PD, the therapeutic approach is essentially based on pharmacological replacement of dopamine levels or direct stimulation of dopaminergic receptors. However, prolonged use of these drugs tends to lose effectiveness. In more advanced stages of the disease, effective therapeutic options are limited, and, to date, there is no treatment capable of preventing or delaying the neurodegenerative process. Thus, the pharmacist’s intervention in the therapy of PD plays a crucial role in ensuring that the therapeutic plan is being followed, while also assessing treatment adherence and effectiveness.
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Doença de Parkinson Doenças Neurodegenerativas Farmacologia Farmacoterapia Farmacêutico