Question

Case 5: Sahita, a 33-year-old female Subjective • The patient is here today for a follow-up regarding a recent diagnosis of Early Onset Parkinson's Disease • Her symptoms include involuntarily motor movements, memory loss, confusion, and balance difficulties • Her medical history includes exposure to heavy pesticides during her work as a farmer chickenpox, migraines, and I pregnancy • Medication List: Sinemet (carbidopa levodopa) 25mg 100mg. Osmolex (amantadine) 100mg. Celexa (citalopram) 40mg. Micronor (norethindrone acetate), and a Multivitamin • Allergy List: Sulfa drugs, penicillins, and ragweed Objective: • On inspection, the patient has a shuffling gait, a fine tremor of the extremities, and muscular rigidity: Vitals are WNL 41. True or False: From a pharmacologic standpoint, there is a cure for Parkinson's Disease a. True b. False 42. Which of the following vitamins, commonly found in multivitamins, is contraindicated in patients living with Parkinson's Disease and those taking a medication with Levodopa as an ingredient? a. BI, Thiamine b. B6, Pyridoxine c. B9, Folic Acid d. B12. Cobalamin 43. What type of medication classification is the patient's Celexa? a. Hypoglycemic b. Selective serotonin reuptake inhibitors c. Sedative d. Proton Pump Inhibitor 44. Extrapyramidal symptoms (EPS) are drug-induced movements that can cause symptoms such as dystonia, akathisia, and parkinsonism. Which of the following drugs can cause EPS? a. Prolixin (fluphenazine) b. Tobradex (tobramycin) c. Vagifem (estradiol hemihydrate) d. Demadex (torsemide) 45. Which of the patient's medications also has efficacy for the treatment of influenza A? a. carbidopa levodopa b. amantadine c. citalopram d. norethindrone 46. The patient's birth control, Micronor (norethindrone) is a synthetic version of what hormone? a. Estrogen b. Progesterone c. Testosterone Tuteinizing hormone

Answer 1

41: false. We can not cure the Parkinson's disease. We can only control the symptoms occuring due to Parkinson's disease.

42: b.B6, pyridoxine. The multivitamin which is contraindicated in patients with Parkinson's disease and who are taking levodppa is pyridoxine. Pyridoxine decreases the effect of levodopa.

43: celexa( citalopram ) belongs to the class of selective searatonin reuptake inhibitors. Generally it is used to treat depression.

44:a. Prolixa( fluphenazine) will show extrapyramidal symptoms.

45: a. Amantadine. Amantidine is an antiviral drug. It also has efficacy to treat influenza A.

46: b. Progesterone. Micronor ( norethindrone ) is the synthetic version of progesterone hormone.