The Impact of Manually Controlled Portable Duodopa Pump on Levodopa Pharmacokinetics and Pharmacodynamics

This paper investigates the clinical performance of a Parkinsons disease patient with respect to the pharmacokinetics and pharmacodynamics features of different drug delivery routes and formulations. From the in-silico analysis conducted and previously reported clinical studies, it is found that a compromising balance is possible between the best symptom relief and least side effects for intra-duodenal infusion compared to oral, intravenous and subcutaneous drug delivery routes. The daily routine with portable duodopa pump in manual mode is studied where extra doses and dose escalation increments are delivered up on demand. Using the in-silico analysis, the daily consumption of Levodopa is calculated based on morning bolus dose, day time maintenance dose and extra doses. But for the patient, it is a tedious task where systematic monitoring of symptoms, meal announcement and mood regulations are required for precise control of Levodopa dose and there by managing the symptoms. The objective of the study is to bring out the effect of manually controlled portable Duodopa pump on the pharmacokinetics and pharmacodynamics of Levodopa. These aspects are to be considered while simulating an artificial substantianigra.