Sinemet represents an anti-dyskinetic combination of carbidopa and levodopa that can treat Parkinson's disease and Parkinsonism (any symptoms caused by other conditions - particularly rigidity and bradykinesia). This medication is sometimes useful in the management of sialorrhea, tremor, and dysphasia.
Carbidopa is a white crystalline compound, an functions as an inhibitor of the aromatic amino acid decarboxylation which helps levodopa (an aromatic amino acid) to reach the brain. The body and the brain transform levodopa into a substance which helps to treat and decrease symptoms of Parkinson disease.
It is known that symptoms of Parkinson's disease are related to the depletion of dopamine in the corpus striatum, but the administration of dopamine is ineffective in the treatment of Parkinson's disease as dopamine does not cross the blood-brain barrier. Levodopa, the metabolic precursor of dopamine is converted to dopamine in the brain because it can cross the blood-brain barrier. Large doses of levodopa are indicated for an efficient effect.
Carbidopa inhibits decarboxylation of peripheral levodopa and it doesn't affect the metabolism of levodopa within the central nervous system. That's why nausea and vomiting are less common with Sinemet than with levodopa.
Sinemet can provide effective long-lasting levodopa plasma levels at doses that are much lower than other doses that are needed with levodopa alone and decreases plasma and urinary dopamine and homovanillic acid.
Sinemet Side Effects
The administration of Sinemet tablets which contain both carbidopa and levodopa produce greater urinary excretion of levodopa in proportion to the excretion of dopamine than administration of the two drugs seperately at separate times.
Typically, an indicated dosage of Sinemet should be one that provides approximately 25% of the previous levodopa dosage.
There are some medical conditions that can interact with Sinemet and a doctor should be consulted before beginning treatment if any of these conditions apply:
* If you are pregnant or breast-feeding
* If you are allergic to food, medicines or other substances
* If you have asthma, lung problems, blood or hormone problems, glaucoma, stomach or intestinal bleeding, mental or mood disorders, seizures, a history of a heart attack.
Do not drink alcohol while using Sinemet, because it may cause drowsiness, dizziness or fainting. This medication should be avoided by children or elderly patients.
All patients should be carefully observed for the development of depression because Sinemet may sometimes cause mental disturbances. During extended therapy periodic evaluation of hematopoetic, renal, and cardiovascular functions are recommended.
Usually patients who receive Sinemet can have adverse effects due to the central neuropharmacologic activity of dopamine. Some other side effects can be found in the following list:
* Anorexia, chest pain, syncope
* Gastrointestinal bleeding, dark saliva, development of duodenal ulcer
* Henoch-Schonlein purpura, urticaria, pruritus
* Depression with or without development of suicidal tendencies, psychotic episodes including delusions, confusion, dream abnormalities, dementia, hallucinations, and paranoid ideation
* Dyspnoea, dark sweat, dark urine, activation of latent Horner's syndrome, pigmentation of teeth and skin, bizarre breathing patterns, urinary incontinence, flatulence, burning sensation of tongue.
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