Clinical pharmacology of levodopa. Part 1.

London : University of London Audio-Visual Centre, 1971.

1 encoded moving image (43.42 min.) : sound, black and white.

00:42:43

University of London

Restricted

In English

Presented by Dr Donald Be Calne. Introduced by Dr Ian Gilliland. Produced by Peter Bowen. Made for British Postgraduate Medical Federation. Made by University of London Audio-visual Centre.

This video is one of around 310 titles, originally broadcast on Channel 7 of the ILEA closed-circuit television network, given to Wellcome Trust from the University of London Audio-Visual Centre shortly after it closed in the late 1980s. Although some of these programmes might now seem rather out-dated, they probably represent the largest and most diversified body of medical video produced in any British university at this time, and give a comprehensive and fascinating view of the state of medical and surgical research and practice in the 1970s and 1980s, thus constituting a contemporary medical-historical archive of great interest. The lectures mostly take place in a small and intimate studio setting and are often face-to-face. The lecturers use a wide variety of resources to illustrate their points, including film clips, slides, graphs, animated diagrams, charts and tables as well as 3-dimensional models and display boards with movable pieces. Some of the lecturers are telegenic while some are clearly less comfortable about being recorded; all are experts in their field and show great enthusiasm to share both the latest research and the historical context of their specialist areas.

Segment 1 Dr Ian Gilliland introduces Dr Donald Calne. Calne speaks to camera and outlines what is to come in the two parts of the lecture. He refers to examples from popular culture which show the way that neuropsychological medications are viewed. He then runs through a detailed history of previous medications used to treat Parkinsonism, their successes and failures. Time start: 00:00:00:00 Time end: 00:05:07:15 Length: 00:05:07:15

Segment 2 Calne continues to look historically at previous treatments of Parkinson's disease, focusing first on stereotactic surgery and showing a table of statistics for follow-up studies on patients who underwent this surgery. Calne now begins to discuss the discovery of levodopa. In a series of tables he compares the effects of dopamine and dopa on the neurological pathways, listing in detail the effects of each. Time start: 00:05:07:15 Time end: 00:09:56:00 Length: 00:04:48:10

Segment 3 Calne looks back to the 1950s when dopa was first discovered, detailing some of the laboratory experiments on it. He refers to microscope images of the neurological nerve cells of a rat to illustrate the ways in which dopa affects these cells. Time start: 00:09:56:00 Time end: 00:13:56:00 Length: 00:00:14:00

Segment 4 Calne describes how, in the 1950s, the drug Reserpine was found to induce Parkinsonism in hospitalised patients; it was noted that Reserpine lowers the levels of dopamine in the brains of the patients. This led to the natural conclusion that a drug such as dopa might increase dopamine levels and reduce the symptoms of Parkinsonism. Levodopa relies upon a balance between acetylcholine and dopamine; Calne refers to a table which compares the effects of both separately and together. Time start: 00:13:56:00 Time end: 00:20:40:00 Length: 00:06:44:00

Segment 5 Calne shows, in table form, the results of therapeutic trials of Levodopa for the treatment of Parkinson's disease. He states, however, that the most important evidence for its effectiveness comes from the experience and anecdotes of the patients using it. He relates the case of a woman whose bank would not accept her signature after taking levodopa because it was too clearly written. Time start: 00:20:40:00 Time end: 00:25:01:12 Length: 00:04:21:12

Segment 6 Still referring to the therapeutic actions of levodopa on the patient, Calne shows a series of short films of patients with Parkinson's diseae. The patients are shown performing a number of activities such as standing, sitting, walking and writing; both before taking levodopa and after. The differences are remarkable. Time start: 00:25:01:12 Time end: 00:30:21:20 Length: 00:05:20:08

Segment 7 Calne moves on to discuss the, sometimes serious, side effects of levodopa. These include nausea, involuntary movements, cardiac arrhythmias, confusion, hallucinations and hypotension. Calne discusses them all and, where possible, suggests a way out of them. Time start: 00:30:21:20 Time end: 00:35:39:10 Length: 00:05:17:15

Segment 8 Calne continues to discuss the side effects of taking levodopa, in particular those causing cardiovascular changes and changes in blood pressure. He explains how some of this can be due to the age of the patient as Parkinsonism usually occurs in the older age group. To illustrate the effects of levodopa on the cardiovascular system, he refers to a study in which eye drops of levodopa were given to a volunteer and the sympathomimetic response recorded. Time start: 00:35:39:10 Time end: 00:40:29:10 Length: 00:04:50:00

Segment 9 Calne shows ECG studies detailing changes in cardiac rhythm following administration of levodopa. He describes how it is important that the tremor of the patients' hands are taken into account when reading the ECG reports. Finally Calne discusses the side effects of increased mobility - underlying conditions such as arthritis may have been masked by the immobility caused by Parkinsonism, but will now come to light. Calne sums up and briefly discusses the topic of Part Two: the pharmacokinetics of levodopa and some other new forms of treatment for Parkinson's disease. Time start: 00:40:29:10 Time end: 00:43:42:05 Length: 00:03:12:20