Parkinson's Disease and Small Farming Community Essay

771 Words May 17th, 2013 4 Pages
Case Study Parkinson’s Disease
Scenario
L.C. is a 78-year-old white man with a 4-year history of Parkinson’s disease (PD). He is a retired engineer, is married, and lives with his wife in a small farming community. He has 4 adult children who live close by. He is taking carbidopa-levodopa, pergolide, and amantadine. L.C. reports that overall he is doing “about the same” as he was at his last clinic visit 6 months ago. He reports that his tremor is about the same, his gait is perhaps a little more unsteady, and his fatigue is slightly more noticeable. L.C. is also concerned about increased drooling. The patient and his wife report that he is taking carbidopa-levodopa 25/100 mg (Sinemet), 1 tablet an hour before breakfast and 1 tablet 2
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It is diagnosed by the symptoms of tremors, rigidity, bradykinesia or akinesia.
5. L.C.’s wife comments “I don’t even know which one of his medicines he takes for his Parkinson’s.” What medications are used for PD and how do you evaluate their effectiveness?
Sinemet is a levodopa-carbidopa drug, it comes in immediate release and a CR form which is a controlled released. This drug is less expensive then the dopamine agonist, and is better for improving motor function. You should give this drug before meals t increase absorption.
Amantadine is symmetrel and it is an antiviral drug that has anti Parkinson benefits, its given early in the disease to reduce symptoms such as dyskinesia.
6. Levodopa is always given in combination with carbidopa. Why? L.C.’s doses of Sinemet are spread over varying times throughout the day. Why?
Carbidopa is a levodopa enhancer, which causes levodopa to be given in a lower dose. (National Parkinson Foundation) You should take Levodopa 30 minutes before meals so that it can be quickly absorbed
7. Generally, PD causes anorexia, decreased sense of smell, constipation, dry mouth, difficulties chewing and swallowing. What interventions are used to address these issues?
Increase fiber and water to help with the constipation. Monitor patients ability to swallow and eat. Provide high protein and high caloric foods or supplements to help maintain weight. Use exercise programs such as tia chi…

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