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Extra resources for みんなの日本語初級1 教え方の手引き Japanese for Everyone Japanese
Taking a higher dose will prolong the time a patient remains above the threshold for dyskinesia to occur, but this is only successful as a short-term measure. Taking larger amounts of levodopa less frequently may decrease the length of time a patient is in the phase of dyskinesia. Sometimes patients only experience Levodopa preparations 37 the onset phase, or only the end-of-dose phase. Many patients probably have a combination of peak-dose and biphasic dyskinesia. Dystonia is also common, the patient often adopting an unusual posture due to the severe and painful muscle contraction; this frequently occurs in the leg.
Unlike Madopar CR, the bioavailability of Sinemet CR is increased with food. Intraduodenal administration As discussed earlier in this chapter, treatment with levodopa will eventually lead to motor complications in the majority of patients including ‘off’ periods and substantial dyskinesias. It has been suggested that at least in part this is due to oral administration of levodopa producing widely fluctuating levels of dopamine in the patient, unlike the continuous supply of dopamine that occurs naturally in the healthy brain.
Further motor complications that arise from the long-term use of levodopa are fluctuations in response either from the ‘end-of-dose’ deterioration (wearing-off effect), or unpredictable on/off switching effect where patients switch between being mobile (‘on’) and immobile (‘off’) suddenly without warning. There are various approaches to managing patients who are experiencing motor complications with levodopa therapy, but success is often the result of trial and error, and experience. Increasing the frequency of doses up to six or more times a day may be beneficial, supporting the belief that peak levels are responsible for the unwanted effects.