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Instructions
Assignment #3: Paper
This paper will summarize the findings of the first two MS
PowerPoint presentations and incorporate them into a paper that
will add an action plan of major tasks, persons or departments
accountable for the actions, time to complete. The time line
with be explained in a narrative manner but will also include an
action plan in graphic plan such as a Gantt chart, PERT chart,
MS Excel spread sheet or just a list of tasks with relevant
information. Students will also identify metrics for the
evaluation of the recommended transformation; explain the risks
for not implementing the changes, the significance of the
strategic and administrative role of Human Resources, and
description of the resources needed for the transformation.
This paper can be used as a sample in a student e-portfolio to
demonstrate knowledge of the strategic and administrative role
of Human Resources. The paper is expected to be written in an
academic style in APA format and include at least six scholarly
sources and their respective in-text citations.
1 Introduction and Purpose of the Paper
2 Summary or Recap from Previous Presentations
3 Summary of the Recommended Action Plan of Major Tasks,
Persons or Departments Accountable, Time to Complete
4 Metrics for Evaluating the Results of the Transformation
5 Risks of Not Implementing the Changes
6 Description of the Significance of Both the Strategic and
Administrative Role of Human
7 Resources Needed for the Transformation (People, Time,
Money, Support from the Top)
8 Summary and Conclusions
9 Appendix, Timeline/Action Plan, Revised Organization
Chart, SWOT Assessment Chart
Criteria
Level 5 Exceeds Expectations
2.5 points
Level 4 Meets Expectations
2.25 points
Level 3 Meets Some Expectations
2 points
Level 2 Does Not Meet Expectations
1.75 points
Level 1 Did Not Submit or Did Not Meet Minimum
Expectations
0 points
Criterion 1 Summary of Recommended Action Plan of Major
Tasks, Persons or Departments Accountable, Time to Complete
Summary is complete, thorough and provides excellent
description of all the major elements. The summary exceeds the
expectations for most papers.
Summary is generally complete, thorough and provides good
description of all the major elements.
Meets some but not all the expectations for being generally
complete, thorough and providing a good description of all the
major elements.
Summary is not complete, thorough and/or does not provide a
good description of all the major elements
Did Not Submit or Did Not Meet Minimum Expectations for a
Capstone Paper
Criterion 2 Metrics for Evaluating the Results of the
Transformation
Metrics are excellent, relevant for the transformation and the
capabilities of the organization; they are linked well to the
objectives of the organization. They exceed the standard
submission for this element of the assignment.
Metrics are good, relevant for the transformation and the
capabilities of the organization; they are linked well to the
objectives of the organization.
Meets some bu not all the expectations of metrics that are
precise and relevant for the transformation and the capabilities
of the organization. They are linked somewhat to the objectives
of the organization.
Metrics are OK and generally relevant for the transformation
and the capabilities of the organization, Could have been even
more precise and relevant.
Did Not Submit or Did Not Meet Minimum Expectations for a
Capstone Paper
Criterion 3 Risks of Not Implementing the Changes
Risks were identified really well, were relevant and explained
in a convincing and professional/academic manner. The risks
were well justified. The segment exceeds most of the
submissions for this part of the assignment.
Risks were identified, were relevant and explained in a
convincing and professional/academic manner. The risks were
well justified. The segment meets the general expectations for
this segment of the assignment.
Meets some of the expectations for the risks being identified,
being relevant and explained in a convincing and
professional/academic manner. The risks were not totally
justified. The segment meets some but not all the general
expectations for this segment of the assignment.
Risks were not identified well or were not relevant or explained
accurately and convincingly.
Did Not Submit or Did Not Meet Minimum Expectations for a
Capstone Paper
Criterion 4 Description of the Significance of Both the Strategic
and Administrative Role of Human Resources
Risks were identified, were relevant and explained in a
convincing and professional/academic manner. The risks were
well justified. The segment meets the general expectations for
this segment of the assignment.
Good insight and description of the significance of both the
strategic and administrative role of Human Resources.
Some insight and description of the significance of both the
strategic and administrative role of Human Resources.
Did not provide adequate insight and/or description of the
significance of both the strategic and administrative role of
Human Resources.
Did Not Submit or Did Not Meet Minimum Expectations for a
Capstone Paper
Criterion 5 Resources Needed for the Transformation (People,
Time, Money, Support from the Top)
All elements of People, Time, Money, Support from the
Top were included and were presented in an exceedingly robust
manner with insight and creativity.
All elements of People, Time, Money, Support from the Top
were included and were presented in a complete manner.
All elements of People, Time, Money, Support from the Top
were included but were not all presented in a complete manner.
All elements of People, Time, Money, Support from the Top
were wither not included or were not presented in a complete
manner.
Did Not Submit or Did Not Meet Minimum Expectations for a
Capstone Paper
Criterion 6 Summary and Conclusions
Robust, thorough and demonstrated excellent knowledge of the
how organizations can transform using the outside in approach.
Exceeded the expectations for the summary and conclusions
segment.
Demonstrated good knowledge of the how organizations can
transform using the outside in approach. Met the expectations
for a capstone class.
Demonstrated fair knowledge of the how organizations can
transform using the outside in approach. Meets some but not all
the expectations for the summary and conclusions for a capstone
class.
Demonstrated some knowledge of the how organizations can
transform using the outside in approach but did not meet the
expectations for a capstone class.
Did Not Submit or Did Not Meet Minimum Expectations for a
Capstone Paper
Criterion 7 Academic Writing Style Including Introduction,
Purpose Statement, Citations and References
Writes in an academic and professional, error free manner,
includes all the required elements, writing is clear, logical,
flows well and is convincing. Citations and references are
provided in accurate APA format. More than the six required
scholarly sources were included. The writing style exceeds most
submissions for the capstone class.
Writes in an academic and professional, error free manner,
includes all the required elements, writing is clear, logical,
flows well and is convincing. Citations and references are
provided in accurate APA format. The six required scholarly
sources were included. The writing style is appropriate for a
capstone class.
Writes in a fairly academic and professional, some errors but
includes most all the required elements, writing is fairly clear,
logical, flows generally well and is somewhat convincing.
Citations and references are provided in almost accurate APA
format. Some but not all the six required scholarly sources were
included. The writing style is not totally appropriate for a
capstone class.
Writing does not meet the expectations of a capstone class.
Does not write in an academic and professional, error free
manner,did not include all the required elements, writing is not
always clear, logical, and does not always flows well. .
Citations and references are not all provided in accurate APA
format. The six required scholarly sources were either not
included or were not relevant.
Did Not Submit or Did Not Meet Minimum Expectations for a
Capstone Paper
Criterion 8 Appendix including Timeline/Action Plan Revised
Organization Chart SWOT Assessment Chart
All needed elements including Timeline/Action Plan, Revised
Organization Chart. and SWOT Assessment Chart were
presented in an excellent format. All were of an exceptional
academic and professional level and exceeding most of the
submissions for the capstone class.
All needed elements including Timeline/Action Plan, Revised
Organization Chart. and SWOT Assessment Chart were
presented in a good format. All were of an acceptable academic
and professional level.
Meets some but not all the expectations for the appendix
section. Some but not all needed elements including
Timeline/Action Plan, Revised Organization Chart. and SWOT
Assessment Chart were presented or were not in a good format.
Some but not all were of an acceptable academic and
professional level.
The needed elements including Timeline/Action Plan, Revised
Organization Chart. and SWOT Assessment Chart were not
presented in a good format or were not included at all. All were
not of an acceptable academic and professional level.
Did Not Submit or Did Not Meet Minimum Expectations for a
Capstone Paper
Overall Score
Level 5 Exceeds Expectations
18.1 or more
Level 4 Meets Expectations
16.1 or more
Level 3 Meets Some Expecations
14.1 or more
Level 2 Does Not Meet Expectations
8 or more
Level 1 Failure
0 or more
18.1 to 20 Points
16.1 to 18 Points
14.1 to 16 Points
8 to 14 Points
Zero Points
Submission Ide: 962eb5f9-a6ba-4cd8-a323-6ce5a6172837
86% SIMILARITY SCORE 2 CITATION ITEMS 63
GRAMMAR ISSUES 0 FEEDBACK COMMENT
Internet Source 86%
Institution 0%
Muhammad Aftkhar
Parkinsonism- Pharmaceutical Treatment Plan.docx
Summary
1
Running Header: PARKINSON'S DISEASE
2
PARKINSON'S DISEASE
-and-
assignment-corection/…
PARKINSON'S DISEASE
MUHAMMAD AFTKHAR
NUR 635 (GCU)
Mar 4th, 2020
Parkinson’s disease
Parkinson's disease is a neuro de-generative disease that occurs
and depletes the neurons
https://www.sciencedirect.com/science/article/abs/pii/S0025619
617308984
https://www.sciencedirect.com/science/article/abs/pii/S1474442
218302394
https://www.sciencedirect.com/science/article/abs/pii/S1043661
818321078
3
PARKINSON'S DISEASE
- generative
-decarboxylase
-decarboxylase
ps://mynursingexperts.com/checking-and-
assignment-corection/…
-dash.: - —
-dash.: - —
present in substansia nigra. These neurons are involved in the
transmission of nerve impulses
from corpus collosum to the substansia nigra part of the mid
brain. These are the character
playing neurons in managing voluntary motor movements in the
body. It mostly occurs in elderly
patients describe by involuntary movements and multi-
dimensional brain functioning. The part
of this disease may occur due to the effective and excessive
use of medications indulging in
bipolar or Alzheimer's disease (Ahlskog, 2018). The decline
of dopamine in par compacta
deteriorates the normal functioning of the brain in controlling
motor activities.
Prescription medication
The prescribed medications used for Parkinson’s disease
includes the use of Levodopa
directly with replenishes the pool for dopamine
neurotransmitter. This drug can’t be given in a
single dose rather without carbidopa (LODOSYN) the
levodopa will break down into dopamine
and then to epinephrine in the body’s periphery. This will
create severe symptomatic side effects
like an increase in heart rate and sympathetic system
dominancy. Dopa-decarboxylase enzyme
breaks down the levodopa in the periphery so along with
levodopa carbidopa is given. This
inhibits the dopa-decarboxylase enzyme and allows levodopa
to travel into the blood brain
barrier easily.
For the calculations of drug regimen there must be
precautionary measures for kidney
and liver sensitive enzyme dependent patients. LFT and RFT’s
for sensitive patients are done to
ensure the correct for dose adjustments not lying in range
affecting kidneys and liver function.
Below are some of the medications for Parkinson’s disease.
a. Agonist of dopamine: - Use of ergot containing drugs like
bromocriptine, ropinirole
(Requip) and pramipexole (Mirapex), They are used for the
patch medication there are
some drugs given in patch because elder patients sometimes
can’t swallow capsules or
tablets may be due to fear so Neupro is given as a patch that
contains rotigotine in it as
active ingredient. Yet another way to administer medication
through injectable which
involves Apokyn has apomorphine as an active participate of
treatment (Xu et.al, 2019).
b. MOA inhibitors: - These are the enzymes that break down the
dopamine in the
periphery of neuron in synaptic cleft. For observing the action,
they are blocked by these
MOA inhibitors (mono amine oxidase inhibitors) including
Zelapar, Eldepryl residing
selegiline in it.
c. COMT inhibitors: - These are the reuptake channels and
enzymatic control of dopamine
from the synaptic cleft. If they are blocked, then there will no
uptake of dopamine in the
neuron and there will be much more dopamine to perform its
function and meet the other
synaptic surface of a leading neuron. Comtan containing
entacapone is used to replenish
dopamine concentration in synaptic cleft and Tasmar as
Tolcapone.
d. Anti-cholinergic: - The use of these medications is to control
the frequency of tremors
and muscles movement which results in the deprivation of
energy and loss of nutrients
from cells resulting in weakening of muscle. Cogentin
containing benztropine is the
chiefly used drug in regimens prescribed by doctors (
Richardson et.al, 2018) .
4
PARKINSON'S DISEASE
5
PARKINSON'S DISEASE
medications in one role (Katzenschlager et.al, 2018). Rather put
elder patients in that category
that deals with the slow and shaking movement of facial
muscles and hands, pill rolling
movement and improved muscle rigidity is seen. Geriatrics has
an affective therapeutic goal in
improving dopamine level in the body.
-dash.: - —
-cholinergic
-dash.: - —
-dash.: - —
Spelling mistake: ropinirole
e. Non- prescribed drug treatment: - Many ways are there for
those patients who wanted
to mend their way in treating of Parkinson disease. Most
effective practices are exercise,
proper muscle movements and massage therapy, speech and
locomotors junction therapy.
Some of the occupational therapy sessions with therapist
recommendations are beneficial
for Parkinsonism. Use of motivated speeches and psychological
sessions will bring
patients from holding the strong grip over their disease and will
think less about it.
Adverse effects and drug –drug interaction
Most probably the use of drugs for one ailment may cause
damage to other parts of the
body if it left unaware or unattended. Especially in the case of
depression therapy and
medication, some of the drugs are related to the origin of
Parkinson disease. Alzheimer's is a
psychotic disorder that may lead to Parkinsonism symptoms
during its treatment. Dementia and
sleeplessness are the most effective adverse effects of drugs
used in Parkinson's disease.
Hallucinations and delusions are also common as these drugs
are used as adjunct therapy for
depression ( Katzenschlager et.al, 2018) .
Warfarin has a severe drug-drug interaction with ropinirole,
and this causes an
anticoagulant effect in the blood which forms less solubility of
drug and interaction mode of the
drug in serum plasma is decreased. Medications use for liver
functioning and kidney assistance
like thiazide diuretics and loop diuretic used in hypertensive
patients will get affected by
ropinirole. Gastric drugs for ulcerations and bleeding in the
small intestine may be enhanced by
the use of levodopa. It will bind to complexes formed by
aluminum hydroxide in gastric track
thus inhibits the efficacy of the drug and formulate ulceration.
Pediatrics and geriatrics
Use of a controlled amount of drug regimens in the clinical
setup there must be an
important note for breast feeding mothers to restrict the
required dose for Parkinson's disease.
Related to pediatrics calculated initiated amount of dosage
regimen is selected. As ropinirole has
severe dementia effect in children. In children, sudden mood
swings and motor impartment
during exercise and running is seen. But improved therapy
sessions have presented the group of
6
PARKINSON'S DISEASE
References
Ahlskog, J. E. (2018, March). Aerobic exercise: evidence for a
direct brain effect to slow
Parkinson disease progression. In Mayo Clinic Proceedings
(Vol. 93, No. 3, pp. 360-372).
Elsevier. Retrieved from
https://www.sciencedirect
.com/science/article/abs/pii/S0025619617308984
Katzenschlager, R., Poewe, W., Rascol, O., Trenkwalder, C.,
Deuschl, G., Chaudhuri, K. R., ...
& Staines, H. (2018). Apomorphine subcutaneous infusion in
patients with Parkinson's disease
with persistent motor fluctuations (TOLEDO): a multicenter,
double-blind, randomized, placebo-
controlled trial. The Lancet Neurology, 17(9), 749-759.
Retrieved from
https://www.sciencedirect.com/science/article/abs/pii/S1474442
218302394
Richardson, K., Fox, C., Maidment, I., Steel, N., Loke, Y. K.,
Arthur, A., ... & Campbell, N. L.
(2018). Anticholinergic drugs and risk of dementia: case-control
study. bmj, 361, k1315.
Xu, W., Reith, M. E., Liu-Chen, L. Y., & Kortagere, S. (2019).
Biased signaling agonist of
dopamine D3 receptor induces receptor internalization
independent of β-arrestin recruitment.
Pharmacological research, 143, 48-57. Retrieved from
https://www.sciencedirect.com/science/article/abs/pii/S1043661
818321078
Select a disease or condition. For example, sepsis, CAD, HCAP,
HAP, hypertension, CHF, atrial fibrillation, depression,
Parkinson's disease, hyperlipidemia, COPD, asthma, and febrile
neutropenia.
Write a 750-1,000 word paper discussing prescription and
nonprescription medications/therapies for the treatment of the
disease. Discuss monitoring and identify significant adverse
effects and drug-drug interactions, as well as desired outcomes
of the pharmacological agents used in the treatment of the
disease. Determine an appropriate pharmaceutical treatment
plan for the disease or condition. Incorporate considerations for
various populations (geriatrics, pediatrics) depending on the
disease you have selected.
You are required to cite three to five sources to complete this
assignment. Sources must be published within the last 5 years
and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the
APA Style Guide, located in the Student Success Center. An
abstract is not required.
This assignment uses a rubric. Review the rubric prior to
beginning the assignment to become familiar with the
expectations for successful completion.
You are required to submit this assignment to LopesWrite.
Refer to the directions in the Student Success Center.
Choose a drug that has been approved by the FDA within the
past year.
Write a 1,000-1,250 word paper in which you:
Describe the drug approved by the FDA. Include the
pharmacodynamics and pharmacokinetic properties of the
chosen drug.
Provide an overview of the disease state for which the drug is
used.
Describe what is different about this agent compared to
currently available therapies.
Discuss the potential risks associated with this agent and any
monitoring parameters that are necessary.
Decide whether you would personally prescribe this agent or
stick with currently available alternatives.
You are required to cite five to 10 sources to complete this
assignment. Sources must be published within the last 5 years
and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the
APA Style Guide, located in the Student Success Center. An
abstract is not required.
This assignment uses a rubric. Review the rubric prior to
beginning the assignment to become familiar with the
expectations for successful completion.
You are required to submit this assignment to LopesWrite.
Refer to the directions in the Student Success Center.
This assignment benchmarks the following competencies:
MS-NUR-ACNP
6.3: Assess the pharmacodynamics and the pharmacokinetic
impact of pharmacologic therapies in the treatment of diseases
and altered states.
7.3: Prescribe appropriate pharmacologic and nonpharmacologic
therapies in the management of illness, disease, or injuries.
Rubic_Print_FormatCourse CodeClass CodeAssignment
TitleTotal PointsNUR-635NUR-635-XO0103XBBenchmark -
Approved Drug by the
FDA120.0CriteriaPercentageUnsatisfactory (0.00%)Less than
Satisfactory (80.00%)Satisfactory (88.00%)Good
(92.00%)Excellent (100.00%)CommentsPoints EarnedContent
70.0%FDA-Approved Drug (Pharmacodynamics and
Pharmacokinetic Properties of the Chosen Drug)(MSN 6.3;
PSTM 1.3)20.0%Description of is not given. Drug chosen is not
FDA-approved; drug approval has not been within the last
year.Explanation of FDA-approved drug is missing relevant
information. The pharmacodynamics and pharmacokinetic
properties of the chosen drug are incomplete.Explanation of
FDA-approved drug is adequately developed. The
pharmacodynamics and pharmacokinetic properties of the
chosen drug are generally presented.Explanation of FDA-
approved drug is developed in detail. The pharmacodynamics
and pharmacokinetic properties of the chosen drug are
presented.Explanation of FDA-approved drug is developed in
detail with thoughtful reflection. The pharmacodynamics and
pharmacokinetic properties of the chosen drug are presented in
detail.Disease State for Which Drug Is Prescribed
20.0%Explanation of disease state for new medication is not
given.Explanation of disease state is missing relevant
information.Explanation of disease state is adequately
developed.Explanation of disease state is developed in
detail.Explanation of disease state is developed in detail with
thoughtful reflection.Comparison of FDA Drug to Currently
Available Therapies15.0%Comparison of new medication to
currently available therapies is missing relevant
information.Comparison of new medication to currently
available therapies is presented, but is missing relevant
information.Comparison of new medication to currently
available therapies is adequately developed.Comparison of new
medication to currently available therapies is developed in
detail.Comparison of new medication to currently available
therapies is thoroughly developed and supported by strong
evidence. Overall comparison demonstrates insight.Potential
Risks, Monitoring, and Prescribing
Likelihood10.0%Explanation of potential risks, monitoring
parameters, and whether one would prescribe the recently
approved medication is not given.Explanation of potential risks,
monitoring parameters, and whether one would prescribe the
recently approved medication is missing relevant
information.Explanation of potential risks, monitoring
parameters, and whether one would prescribe the recently
approved medication is adequately developed.Explanation of
potential risks, monitoring parameters, and whether one would
prescribe the recently approved medication is developed in
detail.Explanation of potential risks, monitoring parameters,
and whether one would prescribe the recently approved
medication is developed in detail with thoughtful
reflection.Required Sources 5.0%Sources are not
included.Number of required sources is only partially
met.Number of required sources is met, but sources are outdated
or inappropriate.Number of required sources is met. Sources are
current, but not all sources are appropriate for the assignment
criteria and nursing content.Number of required resources is
met. Sources are current, and appropriate for the assignment
criteria and nursing content.Organization and Effectiveness
20.0%Thesis Development and Purpose7.0%Paper lacks any
discernible overall purpose or organizing claim.Thesis is
insufficiently developed or vague. Purpose is not clear.Thesis is
apparent and appropriate to purpose.Thesis is clear and
forecasts the development of the paper. Thesis is descriptive
and reflective of the arguments and appropriate to the
purpose.Thesis is comprehensive and contains the essence of the
paper. Thesis statement makes the purpose of the paper
clear.Argument Logic and Construction8.0%Statement of
purpose is not justified by the conclusion. The conclusion does
not support the claim made. Argument is incoherent and uses
noncredible sources.Sufficient justification of claims is lacking.
Argument lacks consistent unity. There are obvious flaws in the
logic. Some sources have questionable credibility.Argument is
orderly, but may have a few inconsistencies. The argument
presents minimal justification of claims. Argument logically,
but not thoroughly, supports the purpose. Sources used are
credible. Introduction and conclusion bracket the thesis.
Argument shows logical progressions. Techniques of
argumentation are evident. There is a smooth progression of
claims from introduction to conclusion. Most sources are
authoritative.Clear and convincing argument that presents a
persuasive claim in a distinctive and compelling manner. All
sources are authoritative.Mechanics of Writing (includes
spelling, punctuation, grammar, language use5.0%Surface errors
are pervasive enough that they impede communication of
meaning. Inappropriate word choice or sentence construction is
used.Frequent and repetitive mechanical errors distract the
reader. Inconsistencies in language choice (register) or word
choice are present. Sentence structure is correct but not
varied.Some mechanical errors or typos are present, but they are
not overly distracting to the reader. Correct and varied sentence
structure and audience-appropriate language are employed.Prose
is largely free of mechanical errors, although a few may be
present. The writer uses a variety of effective sentence
structures and figures of speech.Writer is clearly in command of
standard, written, academic English.Format10.0%Paper Format
(Use of appropriate style for the major and
assignment)5.0%Template is not used appropriately or
documentation format is rarely followed correctly.Template is
used, but some elements are missing or mistaken; lack of
control with formatting is apparent.Template is used, and
formatting is correct, although some minor errors may be
present. Template is fully used; There are virtually no errors in
formatting style.All format elements are correct. Documentation
of Sources (citations, footnotes, references, bibliography, etc.,
as appropriate to assignment and style)5.0%Sources are not
documented.Documentation of sources is inconsistent or
incorrect, as appropriate to assignment and style, with numerous
formatting errors.Sources are documented, as appropriate to
assignment and style, although some formatting errors may be
present.Sources are documented, as appropriate to assignment
and style, and format is mostly correct. Sources are completely
and correctly documented, as appropriate to assignment and
style, and format is free of error.Total Weightage100%
Rubic_Print_FormatCourse CodeClass CodeAssignment
TitleTotal PointsNUR-635NUR-635-XO0103XBPharmaceutical
Treatment Plan100.0CriteriaPercentageUnsatisfactory
(0.00%)Less than Satisfactory (80.00%)Satisfactory
(88.00%)Good (92.00%)Excellent (100.00%)CommentsPoints
EarnedContent70.0%Prescription and Nonprescription
Medications25.0%Explanation of mechanism of action,
pharmacologic category, and pharmacotherapeutic interventions
for prescription and nonprescription medications is not
given.Explanation of mechanism of action, pharmacologic
category, and pharmacotherapeutic interventions for
prescription and nonprescription medications is missing
relevant information.Explanation of mechanism of action,
pharmacologic category, and pharmacotherapeutic interventions
for prescription and nonprescription medications is adequately
developed.Explanation of mechanism of action, pharmacologic
category, and pharmacotherapeutic interventions for
prescription and nonprescription medications is developed in
detail.Explanation of mechanism of action, pharmacologic
category, and pharmacotherapeutic interventions for
prescription and nonprescription medications is developed in
detail with thoughtful reflection.Medication Monitoring,
Adverse Effects and Drug-Drug Interactions, and Desired
Outcomes20.0%Explanation of monitoring, significant adverse
effects, drug-drug interactions, and desired outcomes is not
given.Explanation of monitoring, significant adverse effects,
drug-drug interactions, and desired outcomes is missing
relevant information.Explanation of monitoring, significant
adverse effects, drug-drug interactions, and desired outcomes is
adequately developed.Explanation of monitoring, significant
adverse effects, drug-drug interactions, and desired outcomes is
developed in detail.Explanation of monitoring, significant
adverse effects, drug-drug interactions, and desired outcomes is
developed in detail with thoughtful reflection.Pharmaceutical
Treatment Plan20.0%A pharmaceutical treatment plan for the
disease or condition is not presented. An incomplete
pharmaceutical treatment plan is presented. The treatment plan
is not relevant for the disease or condition presented in the
paper. The plan does not incorporate considerations for the
various populations affected by the condition or disease.A
pharmaceutical treatment plan is presented. Aspects of the
treatment plan are unclear; or, the plan does not present the
most effective course of pharmaceutical treatment for the
disease or condition. A pharmaceutical treatment plan is
presented. The plan presents an effective course of
pharmaceutical treatment for the disease or condition. Some
detail or evidence is required to demonstrate support for the
plan.A pharmaceutical treatment plan is presented. The plan
presents a clear and effective course of pharmaceutical
treatment for the disease or condition. Strong detail and
evidence are presented that demonstrate support for the plan.
The plan illustrates insight into pharmaceutical treatment for
the disease or condition.Required Sources 5.0%Sources are not
included.Number of required sources is only partially
met.Number of required sources is met, but sources are outdated
or inappropriate.Number of required sources is met. Sources are
current, but not all sources are appropriate for the assignment
criteria and nursing content.Number of required resources is
met. Sources are current, and appropriate for the assignment
criteria and nursing content.Organization and Effectiveness
20.0%Thesis Development and Purpose7.0%Paper lacks any
discernible overall purpose or organizing claim.Thesis is
insufficiently developed or vague. Purpose is not clear.Thesis is
apparent and appropriate to purpose.Thesis is clear and
forecasts the development of the paper. Thesis is descriptive
and reflective of the arguments and appropriate to the
purpose.Thesis is comprehensive and contains the essence of the
paper. Thesis statement makes the purpose of the paper
clear.Argument Logic and Construction8.0%Statement of
purpose is not justified by the conclusion. The conclusion does
not support the claim made. Argument is incoherent and uses
noncredible sources.Sufficient justification of claims is lacking.
Argument lacks consistent unity. There are obvious flaws in the
logic. Some sources have questionable credibility.Argument is
orderly, but may have a few inconsistencies. The argument
presents minimal justification of claims. Argument logically,
but not thoroughly, supports the purpose. Sources used are
credible. Introduction and conclusion bracket the thesis.
Argument shows logical progressions. Techniques of
argumentation are evident. There is a smooth progression of
claims from introduction to conclusion. Most sources are
authoritative.Clear and convincing argument that presents a
persuasive claim in a distinctive and compelling manner. All
sources are authoritative.Mechanics of Writing (includes
spelling, punctuation, grammar, language use)5.0%Surface
errors are pervasive enough that they impede communication of
meaning. Inappropriate word choice or sentence construction is
used.Frequent and repetitive mechanical errors distract the
reader. Inconsistencies in language choice (register) or word
choice are present. Sentence structure is correct but not
varied.Some mechanical errors or typos are present, but they are
not overly distracting to the reader. Correct and varied sentence
structure and audience-appropriate language are employed.Prose
is largely free of mechanical errors, although a few may be
present. The writer uses a variety of effective sentence
structures and figures of speech.Writer is clearly in command of
standard, written, academic English.Format10.0%Paper Format
(Use of appropriate style for the major and
assignment)5.0%Template is not used appropriately or
documentation format is rarely followed correctly.Template is
used, but some elements are missing or mistaken; lack of
control with formatting is apparent.Template is used, and
formatting is correct, although some minor errors may be
present. Template is fully used; There are virtually no errors in
formatting style.All format elements are correct. Documentation
of Sources (citations, footnotes, references, bibliography, etc.,
as appropriate to assignment and style)5.0%Sources are not
documented.Documentation of sources is inconsistent or
incorrect, as appropriate to assignment and style, with numerous
formatting errors.Sources are documented, as appropriate to
assignment and style, although some formatting errors may be
present.Sources are documented, as appropriate to assignment
and style, and format is mostly correct. Sources are completely
and correctly documented, as appropriate to assignment and
style, and format is free of error.Total Weightage100%
Assignment 2
21/01/2020
Assignment 2
Name:
Reg no:
Introduction:…………………………………………………………
……………………………….1 Pharmacodynamics and
pharmacokinetic
properties………………………………………….….2,3 Disease
state:…………………………………………………………………
……………………..….4 Currently available
therapies.…………………………………………………………….
………..5 Monitoring
parameters.……………………………………………………………
.……………….6,7 Personal prescription:
.…………………………………………………………….…………
………7 References
.…………………………………………………………….…………
…………………..8
Table of contents
FDA Approved drug in recent year
Dayvigo (lemborexant) (12/20/2019)
Introduction:
In recent years the brain disorders have affected a large number
of people over the globe. This turning into the fashion of every
single being to overcome productivity and tried to acquire
sleep. Sleep disorders are the most prevailing under this
category, this helps in bringing the health and life span towards
betterment despite warning future depictions. With the
introduction of a new medication in treating insomnia and other
sleep-related disorders, there must some intervention which
helps in manufacturing a structured framework to indulge
effective drug regimens and combinations. Experimental trial
and judgmental predictions are the true yield for the growing
population.
Recent years have diagnosed the most irritating disease these
days which tendered the process of the normal sleep cycle.
Pharmacodynamics:
The arousal and wakefulness are determined by the part of the
hypothalamus in the brain. This depicts the maintenance of
sleep function and its cycle, on the other hand, it demonstrates
the appetite and wakefulness. There are hypocretin proteins in
the brain which are in the range from 10,000 to 25,000 neurons
in the brain. Thus the functioning of a sleep cycle zone is
carefully maintained. Lemborexant (Dayvigo) is now
determined after the clinical trials that it works by binding to
one of the two receptors of hypocretin in the brain. This
increases the arousal and appetite requirement in the body. And
tends to cause sleep occurrence.
· In another way, it may directly bind to the receptors in the
brain after passing through the CNS into neurons of the
hypothalamus. Due to high lipoprotein functional groups and
bioavailability in blood serum, it can easily pass from the
blood-brain barrier. Orexin receptors in the brain are working
antagonism to the sleep cycle thus they are antagonized by
Dayvigo when administered.
· There are two types of receptors of orexin OX1 and OX2, both
of them are blocked by the dual blocking ability of Dayvigo.
Due to this dual antagonism function justification for ground
reality sleep cycle is beginning.
· Related to recent research some of the familiar drugs may
cause severe adverse effects due to single antagonism either of
OX1 or OX2.
In this, the hypocretin refers to the embedded genes st4rucutre
and the functioning in order to transcript the usual sleep cycle
for normal physiology. Disturbance in the peptide chain
imbalance for orexin is recommended in postsynaptic disorders
in the brain.
Arousal and appetite stimulants are much recommended and
preferred choice for the determination of good Dayvigo
working. It diminishes the time for onset of rapid eye movement
which is the latent period for sleep occurrence by antagonizing
oxer in receptors found in the hypothalamus directed to control
the sleep cycle and appetite.
Pharmacokinetic:
After judging the proper renal functioning and liver metabolic
processes Lemborexant is treated under total balanced plasma
concentration. The area under the curve shows the experimental
property for determining the highest plasma available protein
binding and free drug. The more free drug is there more will the
penetration for Dayvigo in the blood brain barrier.
Area under the curve:
The area under the curve for time and concentration has set the
goal intervention for 0.8 hours to 0.4 hours implementation
dosage. In an average weight of patients ranging from 45-60 kg,
the division of drug distribution is followed by the affected
dosage regimen depending upon the age factor.
The C max for Dayvigo after administration through the oral
route is judge by drawing the graph for %age obtained through
the curve calculations by integration of log. High fat and other
protein content before obtaining the drug will decrease the C
max of the drug after its distribution in blood plasma.
After the co-administration with other medications, the use of
Dayvigo is depicted to be rendered for another purpose. It may
be involved in hypnosis and psychosis either for delusional
interventions. Ground realities for experimentations have shown
the right administration with anti-depressants in the case of
allowing better efficacy and guided results.
Disease state:
In insomnia, the normal sleep cycle referring to the latent sleep
period and wakefulness is mismanaged. This brings a graph of
decline in the health of fetuses if given to pregnant women,
allowing passing through the umbilical cord depositing in the
fetus's brain. As it has much more lipid penetration power so
the adverse effects are more dominant.
Dayvigo antagonizes the orexin receptors in the brain present in
the hypothalamus. Due to antagonism receptors are restricted to
perform the wakefulness and cause insomnia so sleep-waking is
also impaired.
Difference between currently available therapies:
The use for currently available therapies is Davigo which held
at the same door for the functioning in pharmacokinetic
properties. Rather use in adjuncts some of them are used in
parallel fashion just to organize and indulge further
specification and prevent complications in a disease state.
After randomized clinical trials and other drug interventions,
there are several procedures that form the basis in formulary
and dosage regimen. Rats were being used for effective drug
purpose and other drug differences yielding good results.
Monitoring parameters:
Most of the drug's adverse effects and safety profiles are under
the guideline of the therapeutic window which depicts the
clinical efficacy of a drug user for a specific patient. In order to
endure the kidney and liver acceptability, there must be an
assurance for brain disorders testing.
Dementia and delusions with disorganized sleep patterns may
groom into the natural body attaining the highest possible
conditions for change. The reason for good plasma albumin
binding capacity is to determine oncotic and vessel friction
apparatus working properly also in glomerulus so no leaking of
proteins occurs normally in urine formation.
Patient age, sex, weight properties are managed and determine
carefully. This brings the historic pectoral representation of
educated and communicable civilians. According to the WHO
sleeping disorders and another brain, malfunctioning is most
prevalent which may be due to hypertension and less diet
merged with healthy nutrients.
Personal prescription:
If one prescribed these medications for treating insomnia it will
be a much better option if used along with muscle relaxant and
hypnotic drugs. These hypnotic and sedative drugs will mimic
the action of Dayvigo and enhance its functional capability.
· Sticking to Dayvigo only will have no dominant effect yet it
also has addictive and dependent properties. So effective
monitoring should be done on the patient if given hypnotics like
this. Dependency is most common so as to treat insomnia for
lifetime therapy but renal compromised patients have to
optimize their dosage regimens unless or until their test reports
are under restricted supervision. Drug index and casual effects
related to drug functions may be shown including delusion,
hallucinations, and dizziness. Order for recognizing the need for
this drug must be consulted and MRI for functioning on a trial
basis.
References:
(n.d.). Retrieved from
https://www.karger.com/Article/Abstract/495045
Espie, & A., C. (2009, December 1). "Stepped Care": A Health
Technology
Solution
for Delivering
Zweerde, T. van der, Straten, A. van, Effting, M., Kyle, S. D.,
& Lancee, J. (2018, May 11). Does online insomnia treatment
reduce depressive symptoms? A randomized controlled trial in
individuals with both insomnia and depressive symptoms:
Psychological Medicine. Retrieved from
https://www.cambridge.org/core/journals/psychological-
medicine/article/does-online-insomnia-treatment-reduce-
depressive-symptoms-a-randomized-controlled-trial-in-
individuals-with-both-insomnia-and-depressive-
symptoms/15B2A4BBF766C4343BEDF81FBF32611C
Hertenstein, E., Feige, B., Gmeiner, T., Kienzler, C.,
Spiegelhalder, K., Johann, A., … Baglioni, C. (2018, November
16). Insomnia as a predictor of mental disorders: A systematic
review and meta-analysis. Retrieved from
https://www.sciencedirect.com/science/article/abs/pii/S1087079
218301138
Chekroud, A. M. (2019, November 1). The Opportunity for
Exercise to Improve Population Mental Health. Retrieved from
https://jamanetwork.com/journals/jamapsychiatry/article-
abstract/2749170?widget=personalizedcontent&previousarticle=
492577
Riemann, D., Nissen, C., Palagini, L., Otte, A., Perlis, M. L., &
Spiegelhalder, K. (2015, April 12). The neurobiology,
investigation, and treatment of chronic insomnia. Retrieved
from
https://www.sciencedirect.com/science/article/abs/pii/S1474442
215000216
Ritterband, L. M. (2017, January 1). Effect of a Web-Based
Cognitive Behavior Therapy for Insomnia Intervention.
Retrieved from
https://jamanetwork.com/journals/jamapsychiatry/article-
abstract/2589161.
Sedov, I. D., Goodman, S. H., & Tomfohr-Madsen, L. M. (2017,
March 24). Insomnia Treatment Preferences During Pregnancy.
Retrieved from
https://www.sciencedirect.com/science/article/abs/pii/S0884217
517300400
Sweetman, A. M., Lack, L. C., Catcheside, P. G., Antic, N. A.,
Chai-Coetzer, C. L., Smith, S. S., … McEvoy, R. D. (2016, May
6). Developing a successful treatment for co-morbid insomnia
and sleep apnoea. Retrieved from
https://www.sciencedirect.com/science/article/abs/pii/S1087079
216300107
Matheson, E., & Hainer, B. L. (2017, July 1). Insomnia:
Pharmacologic Therapy. Retrieved from
https://www.aafp.org/afp/2017/0701/p29.html
Assignment 1
21/01/2020
Assignment 1
Name:
Reg no:
Parkinson’s
disease:………………………………………………………………
……………………2
Prescription
medication::…………………………………………………………
…………………2
Medication / drug-drug
interaction……………………………………………………………
…3,4
References……………………………………………………………
………………………………5
Table of contents
Parkinson’s disease:
Parkinson's disease is a neuro de-generative disease that occurs
and depletes the neurons present in substansia nigra. These
neurons are involved in the transmission of nerve impulses from
corpus collosum to the susbtansia nigra part of the mid brain.
These are the character playing neurons in managing voluntary
motor movements in the body.
It mostly occurs in elderly patients describe by involuntary
movements and multi-dimensional brain functioning. The part
of this disease may occur due to the effective and excessive use
of medications indulging in bi polar or Alzheimer's disease. The
decline of dopamine in par compacta deteriorates the normal
functioning of the brain in controlling motor activities.
Prescription medication:
The prescribed medications used for Parkinson’s disease
includes the use of Levodopa directly with replenishes the pool
for dopamine neurotransmitter.
This drug can’t be given in a single dose rather without
carbidopa (LODOSYN) the levodopa will break down into
dopamine and then to epinephrine in the body’s periphery. This
will create severe symptomatic side effects like an increase in
heart rate and sympathetic system dominancy. Dopa-
decarboxylase enzyme breaks down the levodopa in the
periphery so along with levodopa carbidopa is given. This
inhibits the dopa-decarboxylase enzyme and allows levodopa to
travel into the blood brain barrier easily.
For the calculations of drug regimen there must be
precautionary measures for kidney and liver sensitive enzyme
dependent patients. LFT and RFT’s for sensitive patients are
done to ensure the correct for dose adjustments not lying in
range affecting kidneys and liver function.
Agonist of dopamine:
Use of ergot containing drugs like bromocriptine, ropinirole
(Requip), and containing pramipexole (Mirapex). Use for the
patch medication there are some drugs given in patch because
elder patients sometimes can’t swallow capsules or tablets may
be due to fear so Neupro is given as a patch containing
rotigotine in it as active ingredient.
Yet another way to administer medication through injectable
which involves Apokyn having apomorphine as an active
participate of treatment.
MOA inhibitors:
these are the enzymes that break down the dopamine in the
periphery of neuron in synaptic cleft. For observing the action
they are blocked by these MOA inhibitors (mono amine oxidase
inhibitors) including Zelapar, Eldepryl residing selegiline in it.
COMT inhibitors:
These are the reuptake channels and enzymatic control of
dopamine from the synaptic cleft. If they are blocked then there
will no uptake of dopamine in the neuron and there will be
much more dopamine to perform its function and meet the other
synaptic surface of a leading neuron. Comtan containing
entacapone is used to replenish dopamine concentration in
synaptic cleft and Tasmar as Tolcapone.
Anti-cholinergic:
The use of these mnedications is to control the frequency of
tremors and muscles movement which results in the deprivation
of energy and loss of nutrients from cells resulting in
weakening of muscle.
Cogentin containing benztropine is the chiefly used drug in
regimens prescribed by doctors.
Non- prescribed drug treatment:
Many ways are there for those patients who wanted to mend
their way in treating of Parkinson disease. Most effective
practices are exercise, proper muscle movements and massage
therapy, speech and locomotors junction therapy. Some of the
occupational therapy sessions with therapist recommendations
are beneficial for Parkinsonism.
Use of motivated speeches and psychological sessions will bring
patients from holding the strong grip over their disease and will
think less about it.
Adverse effects and drug –drug interaction:
Most probably the use of drugs for one ailment may cause
damage to other parts of the body if it left unaware or
unattended. Especially in the case of depression therapy and
medication, some of the drugs are related to the origin of
Parkinson disease. Alzheimer's is a psychotic disorder that may
lead to Parkinsonism symptoms during its treatment.
Dementia and sleeplessness are the most effective adverse
effects of drugs used in Parkinson's disease. Hallucinations and
delusions are also common as these drugs are used as adjunct
therapy for depression.
Warfarin has a severe drug-drug interaction with ropinirole and
this causes an anticoagulant effect in the blood which forms less
solubility of drug and interaction mode of the drug in serum
plasma is decreased. Medications use for liver functioning and
kidney assistance like thiazide diuretics and loop diuretic used
in hypertensive patients will get affected by ropinirole. Gastric
drugs for ulcerations and bleeding in the small intestine may be
enhanced by the use of levodopa. It will bind to complexes
formed by aluminum hydroxide in gastric track thus inhibits the
efficacy of the drug and formulate ulceration.
Pediatrics and geriatrics:
Use of a controlled amount of drug regimens in the clinical
setup there must be an important note for breast feeding
mothers to restrict the required dose for Parkinson's disease.
Related to pediatrics calculated initiated amount of dosage
regimen is selected. As ropinirole has severe dementia effect in
children. In children, sudden mood swings and motor
impartment during exercise and running is seen. But improved
therapy sessions have presented the group of medications in one
role. Rather put elder patients in that category that deals with
the slow and shaking movement of facial muscles and hands,
pill rolling movement and improved muscle rigidity is seen.
Geriatrics has an affective therapeutic goal in improving
dopamine level in the body.
References:
Ahlskog, J. E. (2018, March 1). Aerobic Exercise: Evidence for
a Direct Brain Effect to Slow Parkinson Disease Progression.
Retrieved from
https://www.sciencedirect.com/science/article/abs/pii/S0025619
617308984
Bair, J. D., & Oppelt, T. F. (2001, October). Warfarin and
ropinirole interaction. Retrieved from
https://www.ncbi.nlm.nih.gov/pubmed/11675845
Katzenschlager, R., Poewe, W., Rascol, O., Trenkwalder, C.,
Deuschl, G., Chaudhuri, K. R., … Lees, A. (2018, July 25).
Apomorphine subcutaneous infusion in patients with
Parkinson's disease with persistent motor fluctuations
(TOLEDO): a multicentre, double-blind, randomized, placebo-
controlled trial. Retrieved from
https://www.sciencedirect.com/science/article/abs/pii/S1474442
218302394
Parkinson's disease: Parkinson's: Non-drug treatment. (2019,
July 4). Retrieved from
https://www.ncbi.nlm.nih.gov/books/NBK293718/
There are two assignments.
1- You need to check and fix APA style for these assignments
including references
2- You need to read these and check with guidelines for
assignment.
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InstructionsAssignment #3 Paper This paper will summari.docx

  • 1. Instructions Assignment #3: Paper This paper will summarize the findings of the first two MS PowerPoint presentations and incorporate them into a paper that will add an action plan of major tasks, persons or departments accountable for the actions, time to complete. The time line with be explained in a narrative manner but will also include an action plan in graphic plan such as a Gantt chart, PERT chart, MS Excel spread sheet or just a list of tasks with relevant information. Students will also identify metrics for the evaluation of the recommended transformation; explain the risks for not implementing the changes, the significance of the strategic and administrative role of Human Resources, and description of the resources needed for the transformation. This paper can be used as a sample in a student e-portfolio to demonstrate knowledge of the strategic and administrative role of Human Resources. The paper is expected to be written in an academic style in APA format and include at least six scholarly sources and their respective in-text citations. 1 Introduction and Purpose of the Paper 2 Summary or Recap from Previous Presentations 3 Summary of the Recommended Action Plan of Major Tasks, Persons or Departments Accountable, Time to Complete 4 Metrics for Evaluating the Results of the Transformation 5 Risks of Not Implementing the Changes 6 Description of the Significance of Both the Strategic and Administrative Role of Human 7 Resources Needed for the Transformation (People, Time, Money, Support from the Top)
  • 2. 8 Summary and Conclusions 9 Appendix, Timeline/Action Plan, Revised Organization Chart, SWOT Assessment Chart Criteria Level 5 Exceeds Expectations 2.5 points Level 4 Meets Expectations 2.25 points Level 3 Meets Some Expectations 2 points Level 2 Does Not Meet Expectations 1.75 points Level 1 Did Not Submit or Did Not Meet Minimum Expectations 0 points Criterion 1 Summary of Recommended Action Plan of Major Tasks, Persons or Departments Accountable, Time to Complete Summary is complete, thorough and provides excellent description of all the major elements. The summary exceeds the expectations for most papers. Summary is generally complete, thorough and provides good description of all the major elements. Meets some but not all the expectations for being generally complete, thorough and providing a good description of all the major elements. Summary is not complete, thorough and/or does not provide a good description of all the major elements Did Not Submit or Did Not Meet Minimum Expectations for a Capstone Paper Criterion 2 Metrics for Evaluating the Results of the Transformation Metrics are excellent, relevant for the transformation and the capabilities of the organization; they are linked well to the objectives of the organization. They exceed the standard
  • 3. submission for this element of the assignment. Metrics are good, relevant for the transformation and the capabilities of the organization; they are linked well to the objectives of the organization. Meets some bu not all the expectations of metrics that are precise and relevant for the transformation and the capabilities of the organization. They are linked somewhat to the objectives of the organization. Metrics are OK and generally relevant for the transformation and the capabilities of the organization, Could have been even more precise and relevant. Did Not Submit or Did Not Meet Minimum Expectations for a Capstone Paper Criterion 3 Risks of Not Implementing the Changes Risks were identified really well, were relevant and explained in a convincing and professional/academic manner. The risks were well justified. The segment exceeds most of the submissions for this part of the assignment. Risks were identified, were relevant and explained in a convincing and professional/academic manner. The risks were well justified. The segment meets the general expectations for this segment of the assignment. Meets some of the expectations for the risks being identified, being relevant and explained in a convincing and professional/academic manner. The risks were not totally justified. The segment meets some but not all the general expectations for this segment of the assignment. Risks were not identified well or were not relevant or explained accurately and convincingly. Did Not Submit or Did Not Meet Minimum Expectations for a Capstone Paper Criterion 4 Description of the Significance of Both the Strategic and Administrative Role of Human Resources Risks were identified, were relevant and explained in a convincing and professional/academic manner. The risks were well justified. The segment meets the general expectations for
  • 4. this segment of the assignment. Good insight and description of the significance of both the strategic and administrative role of Human Resources. Some insight and description of the significance of both the strategic and administrative role of Human Resources. Did not provide adequate insight and/or description of the significance of both the strategic and administrative role of Human Resources. Did Not Submit or Did Not Meet Minimum Expectations for a Capstone Paper Criterion 5 Resources Needed for the Transformation (People, Time, Money, Support from the Top) All elements of People, Time, Money, Support from the Top were included and were presented in an exceedingly robust manner with insight and creativity. All elements of People, Time, Money, Support from the Top were included and were presented in a complete manner. All elements of People, Time, Money, Support from the Top were included but were not all presented in a complete manner. All elements of People, Time, Money, Support from the Top were wither not included or were not presented in a complete manner. Did Not Submit or Did Not Meet Minimum Expectations for a Capstone Paper Criterion 6 Summary and Conclusions Robust, thorough and demonstrated excellent knowledge of the how organizations can transform using the outside in approach. Exceeded the expectations for the summary and conclusions segment. Demonstrated good knowledge of the how organizations can transform using the outside in approach. Met the expectations for a capstone class. Demonstrated fair knowledge of the how organizations can transform using the outside in approach. Meets some but not all the expectations for the summary and conclusions for a capstone class.
  • 5. Demonstrated some knowledge of the how organizations can transform using the outside in approach but did not meet the expectations for a capstone class. Did Not Submit or Did Not Meet Minimum Expectations for a Capstone Paper Criterion 7 Academic Writing Style Including Introduction, Purpose Statement, Citations and References Writes in an academic and professional, error free manner, includes all the required elements, writing is clear, logical, flows well and is convincing. Citations and references are provided in accurate APA format. More than the six required scholarly sources were included. The writing style exceeds most submissions for the capstone class. Writes in an academic and professional, error free manner, includes all the required elements, writing is clear, logical, flows well and is convincing. Citations and references are provided in accurate APA format. The six required scholarly sources were included. The writing style is appropriate for a capstone class. Writes in a fairly academic and professional, some errors but includes most all the required elements, writing is fairly clear, logical, flows generally well and is somewhat convincing. Citations and references are provided in almost accurate APA format. Some but not all the six required scholarly sources were included. The writing style is not totally appropriate for a capstone class. Writing does not meet the expectations of a capstone class. Does not write in an academic and professional, error free manner,did not include all the required elements, writing is not always clear, logical, and does not always flows well. . Citations and references are not all provided in accurate APA format. The six required scholarly sources were either not included or were not relevant. Did Not Submit or Did Not Meet Minimum Expectations for a Capstone Paper Criterion 8 Appendix including Timeline/Action Plan Revised
  • 6. Organization Chart SWOT Assessment Chart All needed elements including Timeline/Action Plan, Revised Organization Chart. and SWOT Assessment Chart were presented in an excellent format. All were of an exceptional academic and professional level and exceeding most of the submissions for the capstone class. All needed elements including Timeline/Action Plan, Revised Organization Chart. and SWOT Assessment Chart were presented in a good format. All were of an acceptable academic and professional level. Meets some but not all the expectations for the appendix section. Some but not all needed elements including Timeline/Action Plan, Revised Organization Chart. and SWOT Assessment Chart were presented or were not in a good format. Some but not all were of an acceptable academic and professional level. The needed elements including Timeline/Action Plan, Revised Organization Chart. and SWOT Assessment Chart were not presented in a good format or were not included at all. All were not of an acceptable academic and professional level. Did Not Submit or Did Not Meet Minimum Expectations for a Capstone Paper Overall Score Level 5 Exceeds Expectations 18.1 or more Level 4 Meets Expectations 16.1 or more Level 3 Meets Some Expecations 14.1 or more Level 2 Does Not Meet Expectations 8 or more Level 1 Failure 0 or more 18.1 to 20 Points 16.1 to 18 Points
  • 7. 14.1 to 16 Points 8 to 14 Points Zero Points Submission Ide: 962eb5f9-a6ba-4cd8-a323-6ce5a6172837 86% SIMILARITY SCORE 2 CITATION ITEMS 63 GRAMMAR ISSUES 0 FEEDBACK COMMENT Internet Source 86% Institution 0% Muhammad Aftkhar Parkinsonism- Pharmaceutical Treatment Plan.docx Summary 1 Running Header: PARKINSON'S DISEASE 2 PARKINSON'S DISEASE -and- assignment-corection/… PARKINSON'S DISEASE
  • 8. MUHAMMAD AFTKHAR NUR 635 (GCU) Mar 4th, 2020 Parkinson’s disease Parkinson's disease is a neuro de-generative disease that occurs and depletes the neurons https://www.sciencedirect.com/science/article/abs/pii/S0025619 617308984 https://www.sciencedirect.com/science/article/abs/pii/S1474442 218302394 https://www.sciencedirect.com/science/article/abs/pii/S1043661 818321078 3 PARKINSON'S DISEASE - generative
  • 10. -dash.: - — present in substansia nigra. These neurons are involved in the transmission of nerve impulses from corpus collosum to the substansia nigra part of the mid brain. These are the character playing neurons in managing voluntary motor movements in the body. It mostly occurs in elderly patients describe by involuntary movements and multi- dimensional brain functioning. The part of this disease may occur due to the effective and excessive use of medications indulging in
  • 11. bipolar or Alzheimer's disease (Ahlskog, 2018). The decline of dopamine in par compacta deteriorates the normal functioning of the brain in controlling motor activities. Prescription medication The prescribed medications used for Parkinson’s disease includes the use of Levodopa directly with replenishes the pool for dopamine neurotransmitter. This drug can’t be given in a single dose rather without carbidopa (LODOSYN) the levodopa will break down into dopamine and then to epinephrine in the body’s periphery. This will create severe symptomatic side effects like an increase in heart rate and sympathetic system dominancy. Dopa-decarboxylase enzyme breaks down the levodopa in the periphery so along with levodopa carbidopa is given. This inhibits the dopa-decarboxylase enzyme and allows levodopa to travel into the blood brain barrier easily. For the calculations of drug regimen there must be precautionary measures for kidney and liver sensitive enzyme dependent patients. LFT and RFT’s
  • 12. for sensitive patients are done to ensure the correct for dose adjustments not lying in range affecting kidneys and liver function. Below are some of the medications for Parkinson’s disease. a. Agonist of dopamine: - Use of ergot containing drugs like bromocriptine, ropinirole (Requip) and pramipexole (Mirapex), They are used for the patch medication there are some drugs given in patch because elder patients sometimes can’t swallow capsules or tablets may be due to fear so Neupro is given as a patch that contains rotigotine in it as active ingredient. Yet another way to administer medication through injectable which involves Apokyn has apomorphine as an active participate of treatment (Xu et.al, 2019). b. MOA inhibitors: - These are the enzymes that break down the dopamine in the periphery of neuron in synaptic cleft. For observing the action, they are blocked by these MOA inhibitors (mono amine oxidase inhibitors) including Zelapar, Eldepryl residing selegiline in it.
  • 13. c. COMT inhibitors: - These are the reuptake channels and enzymatic control of dopamine from the synaptic cleft. If they are blocked, then there will no uptake of dopamine in the neuron and there will be much more dopamine to perform its function and meet the other synaptic surface of a leading neuron. Comtan containing entacapone is used to replenish dopamine concentration in synaptic cleft and Tasmar as Tolcapone. d. Anti-cholinergic: - The use of these medications is to control the frequency of tremors and muscles movement which results in the deprivation of energy and loss of nutrients from cells resulting in weakening of muscle. Cogentin containing benztropine is the chiefly used drug in regimens prescribed by doctors ( Richardson et.al, 2018) . 4 PARKINSON'S DISEASE 5 PARKINSON'S DISEASE medications in one role (Katzenschlager et.al, 2018). Rather put
  • 14. elder patients in that category that deals with the slow and shaking movement of facial muscles and hands, pill rolling movement and improved muscle rigidity is seen. Geriatrics has an affective therapeutic goal in improving dopamine level in the body. -dash.: - — -cholinergic -dash.: - — -dash.: - —
  • 15. Spelling mistake: ropinirole e. Non- prescribed drug treatment: - Many ways are there for those patients who wanted to mend their way in treating of Parkinson disease. Most effective practices are exercise,
  • 16. proper muscle movements and massage therapy, speech and locomotors junction therapy. Some of the occupational therapy sessions with therapist recommendations are beneficial for Parkinsonism. Use of motivated speeches and psychological sessions will bring patients from holding the strong grip over their disease and will think less about it. Adverse effects and drug –drug interaction Most probably the use of drugs for one ailment may cause damage to other parts of the body if it left unaware or unattended. Especially in the case of depression therapy and medication, some of the drugs are related to the origin of Parkinson disease. Alzheimer's is a psychotic disorder that may lead to Parkinsonism symptoms during its treatment. Dementia and sleeplessness are the most effective adverse effects of drugs used in Parkinson's disease. Hallucinations and delusions are also common as these drugs are used as adjunct therapy for depression ( Katzenschlager et.al, 2018) . Warfarin has a severe drug-drug interaction with ropinirole, and this causes an
  • 17. anticoagulant effect in the blood which forms less solubility of drug and interaction mode of the drug in serum plasma is decreased. Medications use for liver functioning and kidney assistance like thiazide diuretics and loop diuretic used in hypertensive patients will get affected by ropinirole. Gastric drugs for ulcerations and bleeding in the small intestine may be enhanced by the use of levodopa. It will bind to complexes formed by aluminum hydroxide in gastric track thus inhibits the efficacy of the drug and formulate ulceration. Pediatrics and geriatrics Use of a controlled amount of drug regimens in the clinical setup there must be an important note for breast feeding mothers to restrict the required dose for Parkinson's disease. Related to pediatrics calculated initiated amount of dosage regimen is selected. As ropinirole has severe dementia effect in children. In children, sudden mood swings and motor impartment during exercise and running is seen. But improved therapy sessions have presented the group of
  • 18. 6 PARKINSON'S DISEASE References Ahlskog, J. E. (2018, March). Aerobic exercise: evidence for a direct brain effect to slow Parkinson disease progression. In Mayo Clinic Proceedings (Vol. 93, No. 3, pp. 360-372). Elsevier. Retrieved from https://www.sciencedirect .com/science/article/abs/pii/S0025619617308984 Katzenschlager, R., Poewe, W., Rascol, O., Trenkwalder, C., Deuschl, G., Chaudhuri, K. R., ... & Staines, H. (2018). Apomorphine subcutaneous infusion in patients with Parkinson's disease with persistent motor fluctuations (TOLEDO): a multicenter, double-blind, randomized, placebo- controlled trial. The Lancet Neurology, 17(9), 749-759. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S1474442 218302394 Richardson, K., Fox, C., Maidment, I., Steel, N., Loke, Y. K., Arthur, A., ... & Campbell, N. L. (2018). Anticholinergic drugs and risk of dementia: case-control
  • 19. study. bmj, 361, k1315. Xu, W., Reith, M. E., Liu-Chen, L. Y., & Kortagere, S. (2019). Biased signaling agonist of dopamine D3 receptor induces receptor internalization independent of β-arrestin recruitment. Pharmacological research, 143, 48-57. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S1043661 818321078 Select a disease or condition. For example, sepsis, CAD, HCAP, HAP, hypertension, CHF, atrial fibrillation, depression, Parkinson's disease, hyperlipidemia, COPD, asthma, and febrile neutropenia. Write a 750-1,000 word paper discussing prescription and nonprescription medications/therapies for the treatment of the disease. Discuss monitoring and identify significant adverse effects and drug-drug interactions, as well as desired outcomes of the pharmacological agents used in the treatment of the disease. Determine an appropriate pharmaceutical treatment plan for the disease or condition. Incorporate considerations for various populations (geriatrics, pediatrics) depending on the disease you have selected. You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content. Prepare this assignment according to the guidelines found in the
  • 20. APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the directions in the Student Success Center. Choose a drug that has been approved by the FDA within the past year. Write a 1,000-1,250 word paper in which you: Describe the drug approved by the FDA. Include the pharmacodynamics and pharmacokinetic properties of the chosen drug. Provide an overview of the disease state for which the drug is used. Describe what is different about this agent compared to currently available therapies. Discuss the potential risks associated with this agent and any monitoring parameters that are necessary. Decide whether you would personally prescribe this agent or stick with currently available alternatives. You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Review the rubric prior to beginning the assignment to become familiar with the
  • 21. expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the directions in the Student Success Center. This assignment benchmarks the following competencies: MS-NUR-ACNP 6.3: Assess the pharmacodynamics and the pharmacokinetic impact of pharmacologic therapies in the treatment of diseases and altered states. 7.3: Prescribe appropriate pharmacologic and nonpharmacologic therapies in the management of illness, disease, or injuries. Rubic_Print_FormatCourse CodeClass CodeAssignment TitleTotal PointsNUR-635NUR-635-XO0103XBBenchmark - Approved Drug by the FDA120.0CriteriaPercentageUnsatisfactory (0.00%)Less than Satisfactory (80.00%)Satisfactory (88.00%)Good (92.00%)Excellent (100.00%)CommentsPoints EarnedContent 70.0%FDA-Approved Drug (Pharmacodynamics and Pharmacokinetic Properties of the Chosen Drug)(MSN 6.3; PSTM 1.3)20.0%Description of is not given. Drug chosen is not FDA-approved; drug approval has not been within the last year.Explanation of FDA-approved drug is missing relevant information. The pharmacodynamics and pharmacokinetic properties of the chosen drug are incomplete.Explanation of FDA-approved drug is adequately developed. The pharmacodynamics and pharmacokinetic properties of the chosen drug are generally presented.Explanation of FDA- approved drug is developed in detail. The pharmacodynamics and pharmacokinetic properties of the chosen drug are presented.Explanation of FDA-approved drug is developed in detail with thoughtful reflection. The pharmacodynamics and
  • 22. pharmacokinetic properties of the chosen drug are presented in detail.Disease State for Which Drug Is Prescribed 20.0%Explanation of disease state for new medication is not given.Explanation of disease state is missing relevant information.Explanation of disease state is adequately developed.Explanation of disease state is developed in detail.Explanation of disease state is developed in detail with thoughtful reflection.Comparison of FDA Drug to Currently Available Therapies15.0%Comparison of new medication to currently available therapies is missing relevant information.Comparison of new medication to currently available therapies is presented, but is missing relevant information.Comparison of new medication to currently available therapies is adequately developed.Comparison of new medication to currently available therapies is developed in detail.Comparison of new medication to currently available therapies is thoroughly developed and supported by strong evidence. Overall comparison demonstrates insight.Potential Risks, Monitoring, and Prescribing Likelihood10.0%Explanation of potential risks, monitoring parameters, and whether one would prescribe the recently approved medication is not given.Explanation of potential risks, monitoring parameters, and whether one would prescribe the recently approved medication is missing relevant information.Explanation of potential risks, monitoring parameters, and whether one would prescribe the recently approved medication is adequately developed.Explanation of potential risks, monitoring parameters, and whether one would prescribe the recently approved medication is developed in detail.Explanation of potential risks, monitoring parameters, and whether one would prescribe the recently approved medication is developed in detail with thoughtful reflection.Required Sources 5.0%Sources are not included.Number of required sources is only partially met.Number of required sources is met, but sources are outdated or inappropriate.Number of required sources is met. Sources are
  • 23. current, but not all sources are appropriate for the assignment criteria and nursing content.Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content.Organization and Effectiveness 20.0%Thesis Development and Purpose7.0%Paper lacks any discernible overall purpose or organizing claim.Thesis is insufficiently developed or vague. Purpose is not clear.Thesis is apparent and appropriate to purpose.Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.Argument Logic and Construction8.0%Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.Mechanics of Writing (includes spelling, punctuation, grammar, language use5.0%Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence
  • 24. structure and audience-appropriate language are employed.Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.Writer is clearly in command of standard, written, academic English.Format10.0%Paper Format (Use of appropriate style for the major and assignment)5.0%Template is not used appropriately or documentation format is rarely followed correctly.Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.Template is used, and formatting is correct, although some minor errors may be present. Template is fully used; There are virtually no errors in formatting style.All format elements are correct. Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)5.0%Sources are not documented.Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.Total Weightage100% Rubic_Print_FormatCourse CodeClass CodeAssignment TitleTotal PointsNUR-635NUR-635-XO0103XBPharmaceutical Treatment Plan100.0CriteriaPercentageUnsatisfactory (0.00%)Less than Satisfactory (80.00%)Satisfactory (88.00%)Good (92.00%)Excellent (100.00%)CommentsPoints EarnedContent70.0%Prescription and Nonprescription Medications25.0%Explanation of mechanism of action, pharmacologic category, and pharmacotherapeutic interventions for prescription and nonprescription medications is not given.Explanation of mechanism of action, pharmacologic category, and pharmacotherapeutic interventions for prescription and nonprescription medications is missing
  • 25. relevant information.Explanation of mechanism of action, pharmacologic category, and pharmacotherapeutic interventions for prescription and nonprescription medications is adequately developed.Explanation of mechanism of action, pharmacologic category, and pharmacotherapeutic interventions for prescription and nonprescription medications is developed in detail.Explanation of mechanism of action, pharmacologic category, and pharmacotherapeutic interventions for prescription and nonprescription medications is developed in detail with thoughtful reflection.Medication Monitoring, Adverse Effects and Drug-Drug Interactions, and Desired Outcomes20.0%Explanation of monitoring, significant adverse effects, drug-drug interactions, and desired outcomes is not given.Explanation of monitoring, significant adverse effects, drug-drug interactions, and desired outcomes is missing relevant information.Explanation of monitoring, significant adverse effects, drug-drug interactions, and desired outcomes is adequately developed.Explanation of monitoring, significant adverse effects, drug-drug interactions, and desired outcomes is developed in detail.Explanation of monitoring, significant adverse effects, drug-drug interactions, and desired outcomes is developed in detail with thoughtful reflection.Pharmaceutical Treatment Plan20.0%A pharmaceutical treatment plan for the disease or condition is not presented. An incomplete pharmaceutical treatment plan is presented. The treatment plan is not relevant for the disease or condition presented in the paper. The plan does not incorporate considerations for the various populations affected by the condition or disease.A pharmaceutical treatment plan is presented. Aspects of the treatment plan are unclear; or, the plan does not present the most effective course of pharmaceutical treatment for the disease or condition. A pharmaceutical treatment plan is presented. The plan presents an effective course of pharmaceutical treatment for the disease or condition. Some detail or evidence is required to demonstrate support for the plan.A pharmaceutical treatment plan is presented. The plan
  • 26. presents a clear and effective course of pharmaceutical treatment for the disease or condition. Strong detail and evidence are presented that demonstrate support for the plan. The plan illustrates insight into pharmaceutical treatment for the disease or condition.Required Sources 5.0%Sources are not included.Number of required sources is only partially met.Number of required sources is met, but sources are outdated or inappropriate.Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content.Organization and Effectiveness 20.0%Thesis Development and Purpose7.0%Paper lacks any discernible overall purpose or organizing claim.Thesis is insufficiently developed or vague. Purpose is not clear.Thesis is apparent and appropriate to purpose.Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.Argument Logic and Construction8.0%Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.Mechanics of Writing (includes
  • 27. spelling, punctuation, grammar, language use)5.0%Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.Writer is clearly in command of standard, written, academic English.Format10.0%Paper Format (Use of appropriate style for the major and assignment)5.0%Template is not used appropriately or documentation format is rarely followed correctly.Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.Template is used, and formatting is correct, although some minor errors may be present. Template is fully used; There are virtually no errors in formatting style.All format elements are correct. Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)5.0%Sources are not documented.Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.Total Weightage100% Assignment 2 21/01/2020
  • 28. Assignment 2 Name: Reg no: Introduction:………………………………………………………… ……………………………….1 Pharmacodynamics and pharmacokinetic properties………………………………………….….2,3 Disease state:………………………………………………………………… ……………………..….4 Currently available therapies.……………………………………………………………. ………..5 Monitoring parameters.…………………………………………………………… .……………….6,7 Personal prescription: .…………………………………………………………….………… ………7 References .…………………………………………………………….………… …………………..8 Table of contents
  • 29. FDA Approved drug in recent year Dayvigo (lemborexant) (12/20/2019) Introduction: In recent years the brain disorders have affected a large number of people over the globe. This turning into the fashion of every single being to overcome productivity and tried to acquire sleep. Sleep disorders are the most prevailing under this category, this helps in bringing the health and life span towards betterment despite warning future depictions. With the introduction of a new medication in treating insomnia and other sleep-related disorders, there must some intervention which helps in manufacturing a structured framework to indulge effective drug regimens and combinations. Experimental trial and judgmental predictions are the true yield for the growing population. Recent years have diagnosed the most irritating disease these days which tendered the process of the normal sleep cycle. Pharmacodynamics: The arousal and wakefulness are determined by the part of the hypothalamus in the brain. This depicts the maintenance of sleep function and its cycle, on the other hand, it demonstrates the appetite and wakefulness. There are hypocretin proteins in the brain which are in the range from 10,000 to 25,000 neurons in the brain. Thus the functioning of a sleep cycle zone is carefully maintained. Lemborexant (Dayvigo) is now determined after the clinical trials that it works by binding to one of the two receptors of hypocretin in the brain. This increases the arousal and appetite requirement in the body. And tends to cause sleep occurrence. · In another way, it may directly bind to the receptors in the brain after passing through the CNS into neurons of the hypothalamus. Due to high lipoprotein functional groups and bioavailability in blood serum, it can easily pass from the blood-brain barrier. Orexin receptors in the brain are working
  • 30. antagonism to the sleep cycle thus they are antagonized by Dayvigo when administered. · There are two types of receptors of orexin OX1 and OX2, both of them are blocked by the dual blocking ability of Dayvigo. Due to this dual antagonism function justification for ground reality sleep cycle is beginning. · Related to recent research some of the familiar drugs may cause severe adverse effects due to single antagonism either of OX1 or OX2. In this, the hypocretin refers to the embedded genes st4rucutre and the functioning in order to transcript the usual sleep cycle for normal physiology. Disturbance in the peptide chain imbalance for orexin is recommended in postsynaptic disorders in the brain. Arousal and appetite stimulants are much recommended and preferred choice for the determination of good Dayvigo working. It diminishes the time for onset of rapid eye movement which is the latent period for sleep occurrence by antagonizing oxer in receptors found in the hypothalamus directed to control the sleep cycle and appetite. Pharmacokinetic: After judging the proper renal functioning and liver metabolic processes Lemborexant is treated under total balanced plasma concentration. The area under the curve shows the experimental property for determining the highest plasma available protein binding and free drug. The more free drug is there more will the penetration for Dayvigo in the blood brain barrier. Area under the curve: The area under the curve for time and concentration has set the goal intervention for 0.8 hours to 0.4 hours implementation dosage. In an average weight of patients ranging from 45-60 kg, the division of drug distribution is followed by the affected dosage regimen depending upon the age factor. The C max for Dayvigo after administration through the oral route is judge by drawing the graph for %age obtained through the curve calculations by integration of log. High fat and other
  • 31. protein content before obtaining the drug will decrease the C max of the drug after its distribution in blood plasma. After the co-administration with other medications, the use of Dayvigo is depicted to be rendered for another purpose. It may be involved in hypnosis and psychosis either for delusional interventions. Ground realities for experimentations have shown the right administration with anti-depressants in the case of allowing better efficacy and guided results. Disease state: In insomnia, the normal sleep cycle referring to the latent sleep period and wakefulness is mismanaged. This brings a graph of decline in the health of fetuses if given to pregnant women, allowing passing through the umbilical cord depositing in the fetus's brain. As it has much more lipid penetration power so the adverse effects are more dominant. Dayvigo antagonizes the orexin receptors in the brain present in the hypothalamus. Due to antagonism receptors are restricted to perform the wakefulness and cause insomnia so sleep-waking is also impaired. Difference between currently available therapies: The use for currently available therapies is Davigo which held at the same door for the functioning in pharmacokinetic properties. Rather use in adjuncts some of them are used in parallel fashion just to organize and indulge further specification and prevent complications in a disease state. After randomized clinical trials and other drug interventions, there are several procedures that form the basis in formulary and dosage regimen. Rats were being used for effective drug purpose and other drug differences yielding good results. Monitoring parameters: Most of the drug's adverse effects and safety profiles are under the guideline of the therapeutic window which depicts the clinical efficacy of a drug user for a specific patient. In order to endure the kidney and liver acceptability, there must be an assurance for brain disorders testing. Dementia and delusions with disorganized sleep patterns may
  • 32. groom into the natural body attaining the highest possible conditions for change. The reason for good plasma albumin binding capacity is to determine oncotic and vessel friction apparatus working properly also in glomerulus so no leaking of proteins occurs normally in urine formation. Patient age, sex, weight properties are managed and determine carefully. This brings the historic pectoral representation of educated and communicable civilians. According to the WHO sleeping disorders and another brain, malfunctioning is most prevalent which may be due to hypertension and less diet merged with healthy nutrients. Personal prescription: If one prescribed these medications for treating insomnia it will be a much better option if used along with muscle relaxant and hypnotic drugs. These hypnotic and sedative drugs will mimic the action of Dayvigo and enhance its functional capability. · Sticking to Dayvigo only will have no dominant effect yet it also has addictive and dependent properties. So effective monitoring should be done on the patient if given hypnotics like this. Dependency is most common so as to treat insomnia for lifetime therapy but renal compromised patients have to optimize their dosage regimens unless or until their test reports are under restricted supervision. Drug index and casual effects related to drug functions may be shown including delusion, hallucinations, and dizziness. Order for recognizing the need for this drug must be consulted and MRI for functioning on a trial basis. References: (n.d.). Retrieved from https://www.karger.com/Article/Abstract/495045 Espie, & A., C. (2009, December 1). "Stepped Care": A Health Technology
  • 33. Solution for Delivering Zweerde, T. van der, Straten, A. van, Effting, M., Kyle, S. D., & Lancee, J. (2018, May 11). Does online insomnia treatment reduce depressive symptoms? A randomized controlled trial in individuals with both insomnia and depressive symptoms: Psychological Medicine. Retrieved from https://www.cambridge.org/core/journals/psychological- medicine/article/does-online-insomnia-treatment-reduce- depressive-symptoms-a-randomized-controlled-trial-in- individuals-with-both-insomnia-and-depressive- symptoms/15B2A4BBF766C4343BEDF81FBF32611C Hertenstein, E., Feige, B., Gmeiner, T., Kienzler, C., Spiegelhalder, K., Johann, A., … Baglioni, C. (2018, November 16). Insomnia as a predictor of mental disorders: A systematic review and meta-analysis. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S1087079 218301138 Chekroud, A. M. (2019, November 1). The Opportunity for Exercise to Improve Population Mental Health. Retrieved from https://jamanetwork.com/journals/jamapsychiatry/article-
  • 34. abstract/2749170?widget=personalizedcontent&previousarticle= 492577 Riemann, D., Nissen, C., Palagini, L., Otte, A., Perlis, M. L., & Spiegelhalder, K. (2015, April 12). The neurobiology, investigation, and treatment of chronic insomnia. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S1474442 215000216 Ritterband, L. M. (2017, January 1). Effect of a Web-Based Cognitive Behavior Therapy for Insomnia Intervention. Retrieved from https://jamanetwork.com/journals/jamapsychiatry/article- abstract/2589161. Sedov, I. D., Goodman, S. H., & Tomfohr-Madsen, L. M. (2017, March 24). Insomnia Treatment Preferences During Pregnancy. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0884217 517300400 Sweetman, A. M., Lack, L. C., Catcheside, P. G., Antic, N. A., Chai-Coetzer, C. L., Smith, S. S., … McEvoy, R. D. (2016, May 6). Developing a successful treatment for co-morbid insomnia and sleep apnoea. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S1087079 216300107 Matheson, E., & Hainer, B. L. (2017, July 1). Insomnia:
  • 35. Pharmacologic Therapy. Retrieved from https://www.aafp.org/afp/2017/0701/p29.html Assignment 1 21/01/2020 Assignment 1 Name: Reg no: Parkinson’s disease:……………………………………………………………… ……………………2 Prescription medication::………………………………………………………… …………………2 Medication / drug-drug interaction……………………………………………………………
  • 36. …3,4 References…………………………………………………………… ………………………………5 Table of contents Parkinson’s disease: Parkinson's disease is a neuro de-generative disease that occurs and depletes the neurons present in substansia nigra. These neurons are involved in the transmission of nerve impulses from
  • 37. corpus collosum to the susbtansia nigra part of the mid brain. These are the character playing neurons in managing voluntary motor movements in the body. It mostly occurs in elderly patients describe by involuntary movements and multi-dimensional brain functioning. The part of this disease may occur due to the effective and excessive use of medications indulging in bi polar or Alzheimer's disease. The decline of dopamine in par compacta deteriorates the normal functioning of the brain in controlling motor activities. Prescription medication: The prescribed medications used for Parkinson’s disease includes the use of Levodopa directly with replenishes the pool for dopamine neurotransmitter. This drug can’t be given in a single dose rather without carbidopa (LODOSYN) the levodopa will break down into dopamine and then to epinephrine in the body’s periphery. This will create severe symptomatic side effects like an increase in heart rate and sympathetic system dominancy. Dopa- decarboxylase enzyme breaks down the levodopa in the periphery so along with levodopa carbidopa is given. This inhibits the dopa-decarboxylase enzyme and allows levodopa to travel into the blood brain barrier easily. For the calculations of drug regimen there must be precautionary measures for kidney and liver sensitive enzyme dependent patients. LFT and RFT’s for sensitive patients are
  • 38. done to ensure the correct for dose adjustments not lying in range affecting kidneys and liver function. Agonist of dopamine: Use of ergot containing drugs like bromocriptine, ropinirole (Requip), and containing pramipexole (Mirapex). Use for the patch medication there are some drugs given in patch because elder patients sometimes can’t swallow capsules or tablets may be due to fear so Neupro is given as a patch containing rotigotine in it as active ingredient. Yet another way to administer medication through injectable which involves Apokyn having apomorphine as an active participate of treatment. MOA inhibitors: these are the enzymes that break down the dopamine in the periphery of neuron in synaptic cleft. For observing the action they are blocked by these MOA inhibitors (mono amine oxidase inhibitors) including Zelapar, Eldepryl residing selegiline in it. COMT inhibitors: These are the reuptake channels and enzymatic control of dopamine from the synaptic cleft. If they are blocked then there will no uptake of dopamine in the neuron and there will be much more dopamine to perform its function and meet the other synaptic surface of a leading neuron. Comtan containing entacapone is used to replenish dopamine concentration in synaptic cleft and Tasmar as Tolcapone.
  • 39. Anti-cholinergic: The use of these mnedications is to control the frequency of tremors and muscles movement which results in the deprivation of energy and loss of nutrients from cells resulting in weakening of muscle. Cogentin containing benztropine is the chiefly used drug in regimens prescribed by doctors. Non- prescribed drug treatment: Many ways are there for those patients who wanted to mend their way in treating of Parkinson disease. Most effective practices are exercise, proper muscle movements and massage therapy, speech and locomotors junction therapy. Some of the occupational therapy sessions with therapist recommendations are beneficial for Parkinsonism. Use of motivated speeches and psychological sessions will bring patients from holding the strong grip over their disease and will think less about it. Adverse effects and drug –drug interaction: Most probably the use of drugs for one ailment may cause damage to other parts of the body if it left unaware or unattended. Especially in the case of depression therapy and medication, some of the drugs are related to the origin of Parkinson disease. Alzheimer's is a psychotic disorder that may lead to Parkinsonism symptoms during its treatment. Dementia and sleeplessness are the most effective adverse
  • 40. effects of drugs used in Parkinson's disease. Hallucinations and delusions are also common as these drugs are used as adjunct therapy for depression. Warfarin has a severe drug-drug interaction with ropinirole and this causes an anticoagulant effect in the blood which forms less solubility of drug and interaction mode of the drug in serum plasma is decreased. Medications use for liver functioning and kidney assistance like thiazide diuretics and loop diuretic used in hypertensive patients will get affected by ropinirole. Gastric drugs for ulcerations and bleeding in the small intestine may be enhanced by the use of levodopa. It will bind to complexes formed by aluminum hydroxide in gastric track thus inhibits the efficacy of the drug and formulate ulceration. Pediatrics and geriatrics: Use of a controlled amount of drug regimens in the clinical setup there must be an important note for breast feeding mothers to restrict the required dose for Parkinson's disease. Related to pediatrics calculated initiated amount of dosage regimen is selected. As ropinirole has severe dementia effect in children. In children, sudden mood swings and motor impartment during exercise and running is seen. But improved therapy sessions have presented the group of medications in one role. Rather put elder patients in that category that deals with the slow and shaking movement of facial muscles and hands, pill rolling movement and improved muscle rigidity is seen.
  • 41. Geriatrics has an affective therapeutic goal in improving dopamine level in the body. References: Ahlskog, J. E. (2018, March 1). Aerobic Exercise: Evidence for a Direct Brain Effect to Slow Parkinson Disease Progression. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0025619 617308984 Bair, J. D., & Oppelt, T. F. (2001, October). Warfarin and ropinirole interaction. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/11675845 Katzenschlager, R., Poewe, W., Rascol, O., Trenkwalder, C., Deuschl, G., Chaudhuri, K. R., … Lees, A. (2018, July 25). Apomorphine subcutaneous infusion in patients with Parkinson's disease with persistent motor fluctuations (TOLEDO): a multicentre, double-blind, randomized, placebo- controlled trial. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S1474442 218302394 Parkinson's disease: Parkinson's: Non-drug treatment. (2019, July 4). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK293718/
  • 42. There are two assignments. 1- You need to check and fix APA style for these assignments including references 2- You need to read these and check with guidelines for assignment. 3- You need add more or delete stuff to make it 100% for 100% marks.