Parkinson's disease treatment (COMT inhibitor).
After giving dopamine in its pharmaceutical form, such as Levodopa, in combination with Carbidopa, the decarboxylase enzymes are stopped, and metabolism in the stomach and tissues is reduced.
During this, 3-O-methyldopa is formed by the COMT enzyme in very large quantities, competing with Levodopa to enter the central nervous system.
We will talk about drugs that inhibit the COMT enzyme to prevent competition between dopamine in its pharmaceutical form for receptors in the CNS: Tolcapone, Entacapone.
Mechanism of action:
This class works to stop COMT directly to prevent the formation of the enzyme 3-O-methyldopa, which competes with levodopa to enter the CNS, so the concentration of dopamine in the brain increases because levodopa absorption has increased.
Uses:
Levodopa Carbidopa is usually given in combination with this type of medication to enhance effectiveness.
The severe side effects that were caused by pharmaceutical forms of dopamine are reduced.
Side Effects:
Because the medicine is taken orally and is absorbed by the GI system, nausea and vomiting are bound to occur, and this occurs in addition to loss of appetite and sometimes diarrhea.
When dopamine levels rise, it is normal for a person to feel trembling, hallucinate, have trouble sleeping, and have low blood pressure.
Tolcapone, despite its long duration of action (it is taken in a small dose compared to Entacapone) because it adheres well to albumin, it causes necrosis in the liver.
Precautions:
Caution must be exercised when giving medications to people who suffer from liver problems and to people who are taking anticoagulants, adjusting doses, and selecting the appropriate medication well so as not to cause blood bleeding or liver cirrhosis.