Wednesday, February 20, 2019
Parkinson Disease Essay
N.J. is a 70-year-old man with a 4-year history of Parkinsons distemper (PD). He is a retired engineer, is married, and lives with his wife in a small work community. He has three adult children who live close by. Since his last scream to the clinic 6 months ago, N.J. reports that his tremors be about the same as they were however, further call into question reveals that he feels his gait is perhaps a little more unsteady, and his deteriorate is slightly more noticeable. N.J. is also concerned about increased drooling. Among the medications N.J. takes are carbidopa-levodopa 25/100 mg (Sinemet), one tablet an hour ahead breakfast and one tablet 2 hours after lunch carbidopa-levodopa 50/200 mg (Sinemet CR), one tablet at bedtime and amantadine (Symmetrel) 100 mg at breakfast and bedtime. On the previous visit, he was encouraged to filter out taking the carbidopa-levodopa (Sinemet) more times throughout the day, but he reports that he became very somnolent with that dosing regim en. He also reports that his dyskinetic movements appear to be worsened just after taking his carbidopa-levodopa (Sinemet).1.What is parkinsonism? (7points) shaking palsy is a neurological syndrome characterized by tremor, hypokinesia, rigidity, and postural instability. Parkinsonism is a symptom complex that differs from Parkinson disease. Parkinsonism is any condition that causes a combination of the movement abnormalities seen in Parkinsons disease such as tremor, slow movement, impaired speech or muscle stiffness. Especially seen in results from the loss of dopamine-containing nerve cells.2.What is Parkinsons infirmity?Parkinson disease is a progressive degenerative disorder of the basal ganglia that results in an eventual loss of coordination and control of involuntary motor movement.3.What clinical manifestations did N.J. credit entry he had? List at least 4. (10 points or 2.5 points per answer) N.J. mentioned his gate is decent more unsteady, his fatigue is slightly more n oticeable, his drooling has increased, and his tremors are the same as the last visit.4.What are the clinical manifestations of Parkinsons illness? List at least 7 symptoms (10 points or 1.42 per answer)TremorRigidityBradykinesiaLoss of manual dexterity and power in affected limbs.AchingDroolingLack of facial formulationRhythmic head noddingReduced blinkingSlumped posture tempo disturbance5.N.J.s wife asks you, How do the doctors know N.J. has Parkinsons disease? They never did a lot of tests on him. How is the diagnosis of Parkinsons Disease made? (5 points) Parkinson disease is diagnosed from the physical examination and health history results. In some cases a MRI may be done to pin down down other causes of the symptoms.6.N.J.s wife comments, I dont even know which one of his medicines he takes for his Parkinsons. What medications are used for Parkinsons Disease?Pramipexole ( Mirapex)Ropinirole (Requip)L-dopa (L-dihydroxyphenylalanine)Carbidopa/Levadopa (Sinemet)Carbidopa/leva dopa/entacapme (Stalevo)Amantadine (Symmetrel)Trihexyphendiyl (Artane)Benztropine (Cogentin)7. N.J. asks, If I dont have abundant dopamine, then why dont they give me a dopamine pill? wherefore cant oral dopamine be given as replacement therapy? (5 points) Dopamine cant be given directly because it cant cross the blood-brain barrier, a lie that insulates the brain from the rest of thebody.8. Levodopa is always given in combination with carbidopa. Why? When two drugs are used in combination, therapeutic levels may be achieved with lower doses.