Homework SourseCASE STUDY SCENARIO Mr Lo age 62 years old has been diagnose
CASE STUDY SCENARIO
Mr. Lo, age 62 years old, has been diagnosed with Parkinson’s disease (PD). He lives in downtown Toronto with his husband of 22 years. His initial symptoms were depression, monotonous, indistinct speech, stooped posture, loss of energy, and hand tremors. His physician started him on Sinemet® 300mg/day PO (levodopa-carbidopa combination). While discussing his medication history with him, you find out that he takes a B-complex multivitamin that contains vitamin B6. He also tells you that his husband Joey has told him to take some of his phenothiazine (an antipsychotic) since he thinks it may “lift him out of his depressed mood.”
A year has passed, and when you see Mr. Lo again his symptoms have worsened. He is feeling muscle rigidity, fixed facial expressions, slowed movement, arm numbness, and cognitive difficulty. His physician has changed his Sinemet to Stalevo100 (levodopa- carbidopa-entacopone combination); he has also added pramipexole (Mirapex ER) a dopamine agonist, and an antidepressant for his mood disorder.
Question 3
Mr. Lo asks if he can continue taking his multivitamin while taking Sinemet®. What can you tell him about taking the multivitamin while taking a medication containing levodopa? Explain this with citation and references.
Solution
Answer- yes ,Mr.Lo can continue taking his multivitamin while taking sinemet.
Multivitamin contains vitamin B6 which decreases the effectiveness of levidopa if taken alone.
If carbidopa taken with Levodopa it prevents the interaction of vitamin B6 and Levodopa.
Hence it is safe to take multivitamin with sinemet.
Carbidopa lower the amount of Levodopa that is required and reduces the side effects associated with Levodopa.
Levodopa helps relieve symptoms of Parkinson\'s disease but it does not slow down the progress of disease.
Hence in case shown Mr lo condition had worsened over a period of time.
