Rasagiline Case Study

The dose should be tailored individually to each patient based on their profile and blood pressure control. The initial recommended dose is 2.5 mg daily. Patients with a strongly activated renin-angiotensin-aldosterone system (RAAS) may experience an excessive drop in blood pressure following the initial dose. A starting dose of 1.25 mg Ramipril is recommended in these patients and they should be monitored closely. The dose can be doubled every 2-4 weeks until the target blood pressure is achieved without exceeding the maximum dose allowance of 10 mg daily.

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

To treat symptoms of insomnia or anxiety, she has had trials of lorazepam, clonazepam and temazepam, and in 2016, quetiapine in doses of 25-50mg per day was prescribed.

Another treatment that has been shown to have moderate effectiveness for reducing symptoms of TD is Clonazepam, a GABA-A agonist benzodiazepine. This medication is recommended to be used only on a short-term basis, and not to exceed three months. This recommendation is due mostly to patients demonstrating tolerance to the medication when used long term, and also because of its addictive properties. It is also not recommended for use by the elderly because of the risk of potential drug-to-drug interactions, increased risk for falls, age-related kidney, heart, and liver problems, and psychomotor slowing (Khouzam, 2015). The daily recommended use ranges from 0.5mg to a maximum of 3-4mg/day. It should be noted that patients with severe symptoms of TD are less likely to show a significant decrease in TD with the use of Clonazepam (Khouzam, 2015).

Medications: Risperdal 05mg TID, BID Melatonin 6mg HS and PRN Vistaril 25-50mg ER Visit: None

Anticholinergic drugs help to deal with the increased salivary production and drooling Parkinson's Disease can cause. Tremors, also, are treated this way. Side effects of these include xerostomia, urinary retention, memory loss, and even

The most current medication regimen included Cyclobenzaprine and Acetaminophen. Her past medical history was significant for pre-diabetes, hypertension, and high cholesterol.

This is 50 year old WM. Patient has a history of mood disorder, HTN, and insomnia. The patient's current medications are:

This drug is approved to treat majority of the symptoms for all stages of Alzheimer's. The brand names of Donepezil are Aricept and Aricept ODT. This drug is classified as Cholinesterase Inhibitors, which also include Tacrine also known as Cognex. Donepezil is usually taken in dosage forms of tablets that should be taken orally. The strengths for this prescription are usually 5 mg,10 mg, or 23 mg. The 5 mg, is often white colored, the 10 mg is usually yellow, and the 23 mg is reddish. All three of these dosage forms should be taken once a day in the evening time. They are film coated and disintegrate as taken. The contraindications list that people should not take Aricept if they experience: Neuroleptic Malignant Syndrome, Epileptic Seizure, Atrioventricular Heart Block, very rapid heartbeat - Torsades de Pointes, sick sinus syndrome, Sinus Bradycardia, asthma, Bronchi Muscle Spasm resulting from COPD, stomach or Intestinal Ulcer, bleeding of the stomach or intestines, blockage of urinary bladder, serious muscle damage that may lead to kidney failure, and if they begin to feel faint. There are seven major drug interactions. four hundred and eighty - six moderate drug interactions and one hundred and sixty - nine minor drug interactions involved with Aricept and

Searching through the literature, there does not appear to be any clear conclusions on the optimal dose of Donepezil, Rivastigmine or Galantamine to be used in order to bring about the greatest positive effect. In accordance with that, Donepezil, Rivastigmine and Galantamine have all been seen to cause side effects due to the role they play as drugs interacting with the brain. (Colovic, 2013). Finally, AD pathogenesis and symptomatology vary from patient to patient making individual differences a complex task for researchers and doctors to work around (Lang, 2010). Future research into the field of clinical neuroscience on AD should shed light onto doses of Donepezil, Rivastigmine and Galantamine that bring about the greatest possible effect on AD patients, but remain safe and tolerable. Steps to reduce adverse side effects should be brought to the forefront as this factor may prevent usage of the drugs. Lastly, individual differences should be taken into account upon treatment as drugs can have different effects across patients and

The goal of drug therapy is to control symptoms to the extent possible. Medications vary with the stage of illness; however, individual response is variable and guides the selection of treatments. Types of drugs used include monoamine oxidase (MAO) inhibitors, dopaminergic, dopamine agonists, and anticholinergics. Initially, patients treated with selegiline, amantadine, or anticholinergics. As the diseases progress, levodopa in combination with carbidopa used. Because levodopa eventually loses its effectiveness, dopamine agonists are added to increase the effectiveness of levodopa. Throughout the disease process, various drug combinations are tried to achieve and maintain optimal symptom control with the fewest adverse reactions. Eventually,

Therapeutic Dosage; Adult, child over 45 kg:300-600mg/day PO, or 0.4 mg/kg/hr. Child under 45 kg

The world of science is bursting with rectifications and when it comes to medicine, it is scientist’s goal to prescribe what is best for the patient. A doctor cannot prescribe what is best for a patient if they do not even fully understand the disease they are facing. Postural Orthostatic Tachycardia Syndrome (POTS) is one of the many diseases we do not know about and it makes sense that many doctors would turn out to be treating its symptoms incorrectly. Our knowledge on medication has grown over the years in the case of POTS and we have come to learn that there are medicines we should not prescribe to the patients. These medicines happen to be any type of norepinephrine reuptake transporters (NRI) that contain atomoxetine. This type of medicine

Apomorphine is a strong dopamine agonist which acts like a dopamine to stimulate nerve cells, and these nerve cells then control movement and other body functions. It is not a new Parkinson's disease drug and it is available under the brand name APO-go. The apomorphine solution contains sodium metabisulfite which means that it cannot be used by people with known sulfite sensitivity. During trials of this medication in the pill form it was found that it damaged kidneys. Consequently, further research was carried and so it was recognised that intake of the drug in different methods seemed more beneficial. For example, when apomorphine is present in the form of an injection it carries no risk of kidney injury thus this form has been used for decades.

Medications that can cause interactions include anticoagulants, probenecid, bisphosphonates, angiotensin-converting enzyme (ACE) inhibitors, anticoagulants (Warfarin), antiplatelet medicines (Clopidogrel), aspirin, corticosteroids (Prednisone), heparin, other NSAIDs (Ibuprofen), Rivaroxaban, or Selective Serotonin Reuptake Inhibitors (SSRIs) (Fluoxetine) due to the risk of stomach bleeding may be increased. Bisphosphonates (Alendronate), Cyclosporine, Hydantoins (Phenytoin), Lithium, Methotrexate, Quinolones (Ciprofloxacin), Sulfonamides (Sulfamethoxazole), and Sulfonylureas (Glipizide) side effects may be increased by Naproxen. The effectiveness of Angiotensin-converting enzyme (ACE) inhibitors (Enalapril), Beta-blockers (Propranolol), or diuretics (Furosemide, Hydrochlorothiazide) may be decreased by Naproxen (Lexi-Comp,