Parkinson's Disease Tulip


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Old 01-15-2009, 07:06 AM #1
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Default Handy site to check drug interactions, side effects

www.doublecheckMD.com

Type the drugs you are taking in one box and any unusual symptoms in a second (optional) and it will give you a pretty thorough rundown on what to watch for.
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Born in 1953, 1st symptoms and misdiagnosed as essential tremor in 1992. Dx with PD in 2000.
Currently (2011) taking 200/50 Sinemet CR 8 times a day + 10/100 Sinemet 3 times a day. Functional 90% of waking day but fragile. Failure at exercise but still trying. Constantly experimenting. Beta blocker and ACE inhibitor at present. Currently (01/2013) taking ldopa/carbadopa 200/50 CR six times a day + 10/100 form 3 times daily. Functional 90% of day. Update 04/2013: L/C 200/50 8x; Beta Blocker; ACE Inhib; Ginger; Turmeric; Creatine; Magnesium; Potassium. Doing well.
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"Thanks for this!" says:
bandido1 (01-16-2009), Curious (01-15-2009), girija (01-18-2009), GregD (01-17-2009), lou_lou (01-17-2009), smithclayriley (01-20-2009)

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Old 01-15-2009, 08:05 AM #2
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Thumbs up

Thank you Rick. I'm going to put a copy in the Useful Links Sticky.

Let me know if there are any others that should be placed there.
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Old 01-17-2009, 03:56 PM #3
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Arrow thank you dear rev!

this was a shocker!
Klonopin and levodopa MODERATE risk
Using both of these drugs may decrease the effectiveness of the levodopa.

Medication effectiveness should be monitored, since this drug combination may lead to decreased effectiveness.
MORE ...
Observation for side effects is recommended. The the valium-like medication may need to be stopped if problems develop.
Hide SOURCE +
Note: Original Source for Medical Professionals
MONITOR: Benzodiazepines may decrease the therapeutic effects of levodopa in patients with Parkinson's disease. The mechanism is unknown.

MANAGEMENT: Patients receiving this combination should be monitored for altered clinical response. The benzodiazepine should be discontinued if an interaction is suspected.
~~~~~~~~

Watch closely for the following side effects and notify your physician immediately should any of these develop:
Abnormal bruising or signs of bleeding such as bleeding from the gums, nose, digestive tract, vagina (females), faintness, dizziness, loss of consciousness, or rash (signs of problems with blood clot formation)
(Zoloft, levodopa-carbidopa)
MORE ...

If certain symptoms develop, ask your physician whether you need the following lab tests or other diagnostic tests (if you've not already had them):
Blood tests to assess normal clotting - in people who develop signs of bleeding such as abnormal bruising or signs of bleeding including bleeding from the gums, nose, digestive tract, vagina (females), faintness, dizziness, loss of consciousness, or rash (Zoloft, levodopa-carbidopa)
Platelet counts - should be monitored (Zoloft)
MORE ...

my notes ** after reading I believe most of our problems are caused by levodop/carbidopa medication
synopsis:

Levodopa-carbidopa may cause the following symptoms that are related to decreased mobility:
Akinesia paridoxica (symptoms tend to come and go).
Loss of muscle movement (common)
Choreiform movements in 80% of people
On-off phenomenon. This symptom may occur with high doses
Involuntary eye movements (occasional)
Involuntary jerking (most frequent side effect)
Nocturnal myoclonus (symptoms tend to come and go)
Orthostatic hypotention (in some patients)
Asterixis (rare)

Note: Original Source for Medical Professionals
Carbidopa does not decrease the frequency or severity of adverse reactions related to the central effects of levodopa.

Levodopa has been reported to cause postural hypotension in some patients. Levodopa-carbidopa should therefore be used with caution in patients on antihypertensive therapy and in patients for whom postural hypotension may be particularly likely or dangerous.


Nervous system effects occur in as many as 50% of treated patients on long-term therapy and include involuntary movements and mental status changes most frequently. The types of involuntary movements due to levodopa have been characterized as choreiform, dystonic and dyskinetic. Fluctuations in motor function occur frequently and often increase as the duration of therapy increases.

Choreiform movements due to levodopa therapy may occur in as many as 80% of patients treated for one year and frequently involve facial grimacing, exaggerated chewing and twisting and protrusion of the tongue.


Several types of motor fluctuations may occur and result in "bradykinetic episodes". Some motor fluctuations are related to the timing of dosage administration. For example, patients may experience "peak of the dose dyskinesia" and a wearing-off effect called "end of the dose akinesia". The "wearing-off" may result in early morning dystonia. Such motor fluctuations may be managed by increasing the frequency of dose administration and decreasing the dose administered (or possibly by use of extended release formulations) to achieve a smoother therapeutic effect.


Other motor fluctuations are not related to the timing of dose administration. Such fluctuations are characterized by sudden loss of levodopa effect which may last for minutes to hours and result in akinesia followed by a sudden return of levodopa effect. These "on-off" fluctuations may occur many times per day. "On-off" fluctuations may respond to more frequent dose administration.


Finally, akinesia paridoxica is a sudden episode of akinesia which occurs as patients begin to walk. Akinesia paridoxica frequently results in falls and often responds to levodopa dose reductions.


Other adverse nervous system effects due to levodopa include myoclonus, sleep disturbances (including insomnia, daytime somnolence, altered dreams and episodic nocturnal myoclonus), Meige's syndrome (blepharospasm-oromandibular dystonia) and ocular dyskinesia. In addition, the orofacial movements induced by levodopa have occasionally been reported to cause severe dental erosion.


Some investigators have suggested that levodopa may cause brain dysfunction and may have negative effects on cognitive performance.


Levodopa "drug holidays" have been proposed by some investigators as potentially beneficial (perhaps by causing dopamine receptor resensitization). However, the therapeutic value of these drug holidays is controversial.

Respiratory dyskinesias (occasionally of life-threatening severity) have been reported.

Hepatic effects including asterixis (without abnormalities of liver function tests) have been reported rarely. The manufacturer of levodopa-containing products report that abnormal liver function tests may occur.


MORE ...

Hide SOURCE +
Note: Original Source for Medical Professionals
Carbidopa does not decrease the frequency or severity of adverse reactions related to the central effects of levodopa.

Levodopa has been reported to cause postural hypotension in some patients. Levodopa-carbidopa should therefore be used with caution in patients on antihypertensive therapy and in patients for whom postural hypotension may be particularly likely or dangerous.


Nervous system effects occur in as many as 50% of treated patients on long-term therapy and include involuntary movements and mental status changes most frequently. The types of involuntary movements due to levodopa have been characterized as choreiform, dystonic and dyskinetic. Fluctuations in motor function occur frequently and often increase as the duration of therapy increases.

Choreiform movements due to levodopa therapy may occur in as many as 80% of patients treated for one year and frequently involve facial grimacing, exaggerated chewing and twisting and protrusion of the tongue.


Several types of motor fluctuations may occur and result in "bradykinetic episodes". Some motor fluctuations are related to the timing of dosage administration. For example, patients may experience "peak of the dose dyskinesia" and a wearing-off effect called "end of the dose akinesia". The "wearing-off" may result in early morning dystonia. Such motor fluctuations may be managed by increasing the frequency of dose administration and decreasing the dose administered (or possibly by use of extended release formulations) to achieve a smoother therapeutic effect.


Other motor fluctuations are not related to the timing of dose administration. Such fluctuations are characterized by sudden loss of levodopa effect which may last for minutes to hours and result in akinesia followed by a sudden return of levodopa effect. These "on-off" fluctuations may occur many times per day. "On-off" fluctuations may respond to more frequent dose administration.


Finally, akinesia paridoxica is a sudden episode of akinesia which occurs as patients begin to walk. Akinesia paridoxica frequently results in falls and often responds to levodopa dose reductions.


Other adverse nervous system effects due to levodopa include myoclonus, sleep disturbances (including insomnia, daytime somnolence, altered dreams and episodic nocturnal myoclonus), Meige's syndrome (blepharospasm-oromandibular dystonia) and ocular dyskinesia. In addition, the orofacial movements induced by levodopa have occasionally been reported to cause severe dental erosion.


Some investigators have suggested that levodopa may cause brain dysfunction and may have negative effects on cognitive performance.


Levodopa "drug holidays" have been proposed by some investigators as potentially beneficial (perhaps by causing dopamine receptor resensitization). However, the therapeutic value of these drug holidays is controversial.

Respiratory dyskinesias (occasionally of life-threatening severity) have been reported.

Hepatic effects including asterixis (without abnormalities of liver function tests) have been reported rarely. The manufacturer of levodopa-containing products report that abnormal liver function tests may occur.

*my note - never stop your medications cold turkey without medical professional's approval, It is very dangerous to go off meds cold turkey...

thankyou, Rev!
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lou_lou


.


.
by
.
, on Flickr
pd documentary - part 2 and 3

.


.


Resolve to be tender with the young, compassionate with the aged, sympathetic with the striving, and tolerant with the weak and the wrong. Sometime in your life you will have been all of these.

Last edited by lou_lou; 01-17-2009 at 04:33 PM.
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Old 01-17-2009, 05:04 PM #4
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Default Riding a tiger and it is hard to get off

You are welcome, Tena. Several times I have thought that my symptoms have progressed only to realize that it was simply too much medication.

Does anyone know of any other medication whose symptoms of overdose are the same as those of the disorder being treated?
__________________
Born in 1953, 1st symptoms and misdiagnosed as essential tremor in 1992. Dx with PD in 2000.
Currently (2011) taking 200/50 Sinemet CR 8 times a day + 10/100 Sinemet 3 times a day. Functional 90% of waking day but fragile. Failure at exercise but still trying. Constantly experimenting. Beta blocker and ACE inhibitor at present. Currently (01/2013) taking ldopa/carbadopa 200/50 CR six times a day + 10/100 form 3 times daily. Functional 90% of day. Update 04/2013: L/C 200/50 8x; Beta Blocker; ACE Inhib; Ginger; Turmeric; Creatine; Magnesium; Potassium. Doing well.
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Old 01-18-2009, 10:11 AM #5
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Arrow Rls?

they are giving mirapex and Ldopa tothose w/ Restless Leg Syndrome...
I will visit there forum and ask and I will leave your excellent find link...
okay~
thankyou for sharing the golden link! dear rev!
__________________
with much love,
lou_lou


.


.
by
.
, on Flickr
pd documentary - part 2 and 3

.


.


Resolve to be tender with the young, compassionate with the aged, sympathetic with the striving, and tolerant with the weak and the wrong. Sometime in your life you will have been all of these.
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