Abstract
AbstractPharmacotherapy is the cornerstone of management for Parkinson disease (PD). Pharmacotherapy is the most impactful intervention, and other treatment modalities generally work best in conjunction with judicious pharmacotherapy. Pharmacotherapy is primarily symptomatic dopamine (DA) replacement therapy (DRT) with L-dopa preparations, adjuncts to L-dopa preparations, and/or DA agonists. L-dopa preparations continue to be the best treatment for PD. This chapter reviews the fundamentals of dopaminergic neurotransmission, and L-dopa pharmacokinetics and pharmacodynamics. The potential mechanism of peak dose dyskinesias is reviewed, as are the interactions of disease progression with L-dopa pharmacokinetics and pharmacodynamics.
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