About Parkinson’s Disease
Treatment
• A slow and progressive neurogenerative disorder
that affects approx. 1.5 million people in the U.S.
• Usually affects both men and women over the age
of 40 years old
• Clinical course of the disorder is highly variable to
individual
(Capriotti, 2020)
Pathophysiology
• Progressive loss of dopamine-producing cells in the
substantia nigra (w/in basal ganglia of midbrain)
• Due to a depletion of dopamine, the Ach and dopamine
neurotransmitters create an imbalance, causing
abnormal muscle movements
• 50 to 80% degeneration of the substantia nigra required to
notice signs of disease
• See accumulation of abnormal protein “alpha-synuclein”
(Capriotti, 2020)
Clinical Manifestations
• Classic manifestations include bradykinesia, resting tremor, and
muscle rigidity
• Slow onset with resting tremor seen often as the first symptom of
the disease
• Movements slow or halt with progression of disease
• Symptoms begin unilaterally and progress bilaterally
• With time, walking, dressing, writing, and eating become
challenging
(Capriotti, 2020)
Evaluation
• Diagnosis using mnemonic TRAP:
tremor at rest, rigidity, akinesia or • While there is no cure, treatment focuses on relieving
bradykinesia, and postural/gait symptoms for patient to carry out ADLs
instability • Initial treatment includes dopamine replacement
• Recent studies show a focus on therapy (combination of Levodopa and Carbidopa)
alpha-synuclein labs • Dopamine agonists and MAO-B inhibitors like
• PET scans and SPECT scans may rasagiline can provide symptomatic benefit
show reduction in uptake of • Anticholinergics may be used to treat resting tremor
dopaminergic markers • Deep brain stimulation may help severe symptoms
(Capriotti, 2020) (Capriotti, 2020)
Connection to INP #2
Integrative nursing principle #2 states that
Parkinson’s human beings have an innate capacity for
Disease healing and wellbeing. This holds true to
patients suffering from Parkinson’s disease.
Although uncurable, there are different
nonpharmacological interventions to lessen
symptoms of the disease by promoting the
body’s natural healing (University of Minnesota,
2021).
Integrative Therapies
Example of integrative modalities include exercise therapy to increase
functional independence, motor function, ADLs, and quality of life.
Acupuncture may be used to relieve pain/tension related to muscle rigidity
(Capriotti, 2020).
References
Capriotti, T. (2020). Davis advantage for pathophysiology: Introductory concepts and
clinical perspectives (2nd ed). FA Davis Company.
https://bookshelf.vitalsource.com/reader/books/9781719641470/epubcfi/6/112[
%3Bvnd.vst.idref%3Dc34]!/4/2/2/330/21:283[lie%2Cf
University of Minnesota. (2022). Principles of integrative nursing. Center for Spirituality
& Healing. https://www.csh.umn.edu/education/focus-areas/integrative-
nursing/principles-integrative-nursing