'Parkinson Disease Essay\r'

'N.J. is a 70-year-old man with a 4-year history of Parkinson’s affection (PD). He is a retired engineer, is married, and lives with his wife in a small farming community. He has three great(p) children who live close by. Since his last visit to the clinic 6 months ago, N.J. reports that his tremors are â€Å"about the same” as they were; however, further questioning reveals that he feels his gait is perhaps a little to a greater extent unsteady, and his wear off is slightly more(prenominal) noticeable. N.J. is also concerned about increased drooling. Among the medications N.J. takes are carbidopa-levodopa 25/ vitamin C mg (Sinemet), one contraceptive chit an hour before breakfast and one stamp pad 2 hours after lunch; carbidopa-levodopa 50/ two hundred mg (Sinemet CR), one tablet at bedtime; and amantadine (Symmetrel) 100 mg at breakfast and bedtime. On the anterior visit, he was encouraged to try fetching the carbidopa-levodopa (Sinemet) more times through out the day, but he reports that he became very somnolent with that dosing regimen. He also reports that his dyskinetic movements issue to be worse just after taking his carbidopa-levodopa (Sinemet).\r\n1.What is parkinsonism? (7points)\r\nParkinsonism is a neurological syndrome characterized by tremor, hypokinesia, rigidity, and postural instability. Parkinsonism is a symptom building complex that differs from Parkinson illness. Parkinsonism is any condition that causes a confederacy of the movement abnormalities seen in Parkinson’s disease; much(prenominal) as tremor, slow movement, impaired speech or muscle stiffness. Especially seen in results from the loss of dopamine-containing kindling cells.\r\n2.What is Parkinson’s unsoundness?\r\nParkinson disease is a imperfect degenerative disorder of the basal ganglia that results in an ultimate loss of coordination and control of involuntary motor movement.\r\n3.What clinical manifestations did N.J. mention he had ? List at least(prenominal) 4. (10 points or 2.5 points per answer) N.J. mentioned his gate is becoming more unsteady, his fatigue is slightly more noticeable, his drooling has increased, and his tremors are the same as the last visit.\r\n4.What are the clinical manifestations of Parkinson’s Disease? List at least 7 symptoms (10 points or 1.42 per answer)\r\n•Tremor\r\n•Rigidity\r\n•Bradykinesia\r\n•Loss of dexterity and berth in affected limbs.\r\n•Aching\r\n•Drooling\r\n•Lack of nervus facialis expression\r\n•Rhythmic head nodding\r\n• bring down blinking\r\n•Slumped posture\r\n•Gait disturbance\r\n5.N.J.’s wife asks you, â€Å"How do the doctors bed N.J. has Parkinson’s disease? They never did a lot of tests on him.” How is the diagnosing of Parkinson’s Disease made? (5 points) Parkinson disease is diagnosed from the natural examination and health history results. In slightl y cases a MRI may be make to narrow down other causes of the symptoms.\r\n6.N.J.’s wife comments, â€Å"I jade’t even know which one of his medicines he takes for his Parkinson’s.” What medications are utilise for Parkinson’s Disease?\r\n•Pramipexole ( Mirapex)\r\n•Ropinirole (Requip)\r\n•L-dopa (L-dihydroxyphenylalanine)\r\n•Carbidopa/Levadopa (Sinemet)\r\n•Carbidopa/levadopa/entaca[pme (Stalevo)\r\n•Amantadine (Symmetrel)\r\n•Trihexyphendiyl (Artane)\r\n•Benztropine (Cogentin)\r\n7. N.J. asks, â€Å"If I don’t have enough dopamine, then why don’t they give me a dopamine pill?” Why can’t oral dopamine be given as replacement therapy? (5 points) dopamine can’t be given straight off because it can’t cross the blood-brain barrier, a line drive that insulates the brain from the rest of the body.\r\n8. Levodopa is always given in combination with carbidopa. W hy? When two drugs are used in combination, therapeutic levels may be achieved with discredit doses.\r\n'