This case study presentation involves a 61-year-old male patient with Parkinson's disease, urinary tract infection, and severe edema. He has a history of Parkinson's disease for 8 years and has had a Foley catheter for 1 year. Physical examination finds the patient semiconscious with swelling over his entire body. Laboratory tests show elevated creatinine and sodium levels, as well as pus cells in the urine, indicating urinary tract infection. The patient is diagnosed with Parkinson's disease with urinary tract infection and bacterial endocarditis of prosthetic heart valves. The goals of therapy are to improve quality of life, prevent further complications, and optimize the patient's current treatment plan.

1. CASE STUDY PRESENTATION:
PARKINSON’S DISORDER WITH BEP WITH
SEVERE UTI
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2. SUBJECTIVE DATA
NAME: NBK AGE: 61 SEX: M Weight: 60 kg Height: 168cms
CHIEF COMPLAINTS:
• Dribbling of urine(Foley’s Catheter)
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3. OBJECTIVE DATA
• MEDICAL H/O: Parkinson’s d/o since 8Y, on Foley’s Catheter since 1y
No h/o DM,HTN
• SOCIAL H/O: Married, Clerkship in a bank
• FAMILY H/O: A relative with Alzheimer’s( diagnosed at age 68)
• PREVIOUS ALLERGIES: N/S
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4. PREVIOUS MEDICATIONS
1. TB. Tidomet TDS Levodopa (100mg) + Carbidopa
(25mg)
11.Tb Tramagold SOS Tramadol+ Paracetamol
2 Tb.Pramipex BD Pramipexole HCl 0.25mg 12 Tb Ciplar OD Ciprofloxacin
3 Tb Parkitidin BD Amantadine 100mg 13 Tb Amiflox OD Amoxicillin
4 Tb Renolog OD α-ketoanalog+L-Histidine 14 Tb Xolid OD Linezolid
5Tb Sobsis Forte BD 15 Syp Hepatoglobin Folic Acid+Vit B12
6 Tb Protin-m SOS Drotavarine+Mefanamic acid 16 Syp Renikare TDS 1tsp
7 Cap Urimax OD Tamsulosin 0.4mg 17 Prohance Powder TDS 1tsp
8 Tb Mondeslor prn Montelukast+Desloratidine 18 Tb Fulzaren TDS Faropenem 200mg
9 Tb Nootropil BD Piracetam 10 mg 19 Tb Clopitab OD Clopidogrel
10 Tb Novastat TDS Novastatin 10mg
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5. PHYSICAL EXAMINATION
• GENERAL: semiconscious, afebrile, swelling over entire body
• VITALS: BP- 150/90 Pulse: 78/min SpO2: 96% RR: 24/min
• HEENT: N
• CVS: N
• CNS: semiconscious, responds to verbal commands, doesn’t move or talk
• GIT: ET feeding- 200ml/4h; palpatous,tender
• GU: prostatomegaly, obstructive uropathy,
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6. CBC
 Hb- 13.8 g/dl
 HCT- 37.9
 PLT-197
ROUTINE ANALYSIS
LAB INVESTIGATION
 S.BUN-
12.0mg/dL
 S.Creat-1.2mg/dL
 SGPT-13.4 U/L
 D.Bil-0.3
 I.Bil-0.5
 T.Bil-0.8
 ALP-89IU/L
 S.Alb-3.1g/dL
 S.Glob-2.7g/Dl
 S.Na-118mEq/L
 S.K-4.7mEq/L
 S.Glu-99mg/dL
ABG
 pH-7.45
 pCO2- 30mm Hg
 pO2- 62 mm Hg
 HCO3- 20.9mmol/L
 TCO2- 21.8mmol/L
 Beb- 2.1mmol/L
 BEecf- 3.1mmol/L
 SBC-23.1mmol/L
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7. URINALYSIS
 Sugar- Nil
 Bile salts-Absent
 Bile proteins- Absent
 Microscopic:
a) 70-80 pus cells
b) 2-3 RBCs with bacteria++
c) HPF
C-XR: Chest P/A
o RT noted in situ
o Mild cardiomegaly
o Soft tissue, bony cage reveal normal
features
o Central trachea: Both
hemidiaphragms normal
o Both lung fields normal
o Pulmonary vasculature normal
o IMP: mild cardiomegaly
OTHER INVESTIGATIONS
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8. USG
Moderate ascitis
ECG
QT prolongation
MRI
• Mild BIL Mastoiditis is seen(L>R)
• Few acute non haemorrhagic Lacunar infarcts
in Left corona radiata
• Extreme deepmicrovasculature ischemic foci
in BIL ganglio capsular being chronic lacunar
infarcts
• Mild age appropriate cerebral & cerebellar
atrophy
FURTHER INVESTIGATIONS
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11. Final Diagnosis
ETIOLOGY
Goals of Therapy
• Parkinson’s d/o with UTI with
BEP
• Possible outcome: CKD
• Age
• Sleep cycle disturbance
• To increase quality of life
• Prevent comorbidity, mortality &
further progression of disorder
• Reduce adverse events of current
therapy and optimize therapy
ASSESSMENT TO CURRENT THERAPY
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12.  MOA: Carbapenems inhibit bacterial cell wall synthesis by binding to the penicillin-binding
proteins and interfering with cell wall formation.
 CATEGORY: Antibacterial, Carbapenem
INDICATIONS: Intraabdominal Infection, Nosocomial Pneumonia, Skin and Structure Infectio
nSkin or Soft Tissue Infection, Meningitis
CONTRAINDICATIONS: Seizure
 ADVERSE EVENTS: Constipation ,redness, swelling at the injection site, thrombocytopenia
 PREGNANCY: US FDA pregnancy category: B
 PRECAUTIONS: Tell your doctor about all your other medicines, especially:
divalproex sodium;
probenecid; or
valproic acid.
 STD. DOSE: Reconstitute infusion vials containing 500 mg or 1 g with a compatible IV
solution (e.g., 0.9% sodium chloride, 5% dextrose) to provide solutions containing
approximately 2.5–50 mg/mL.
INJ MEROPENEM IV TDS
500MG(D1-D2)
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13.  GENERIC: Levodopa (100mg) + Carbidopa (25mg)
 CATEGORY: Anti Parkinsonian
 MOA: Levodopa is converted to dopamine via the action of a naturally occurring enzyme called DOPA
decarboxylase. Carbidopa prevents peripheral conversion of levodopa to dopamine and thereby reduces the
unwanted peripheral side effects of levodopa
 INDICATIONS: Parkinson’s associated symptoms, Lewy body dementia
 CONTRAINDICATIONS: Concomitant use with a nonselective MAO inhibitor. Angle-closure glaucoma.,
Known hypersensitivity to levodopa, carbidopa,
 ADVERSE EVENTS: syncope, depression, hallucination, sleep disturbance, Dyskinesias (choreiform, dystonic,
other adventitious movements)
 PREGNANCY: Category C
 PRECAUTIONS: safety and efficacy not established in children <18 years of age
 STD. DOSE: Available in combination products containing a 1:4 or 1:10 ratio of carbidopa to levodopa
TB. TIDOMOT FORTE TDS(D1-D2)
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14.  GENERIC: Pramipexole
 CATEGORY: Anti Parkinsonian
 MOA: Pramipexole binds to dopamine receptors and mimics the actions of dopamine, a naturally
occurring neurotransmitter.
 INDICATIONS: Parkinson’s associated symptoms, Restless leg syndrome
 CONTRAINDICATIONS: Seizure, Psychosis, Lactation
 ADVERSE EVENTS: drowsiness, visual hallucination, constipation, and insomnia. Other side
effects include: xerostomia.
 PREGNANCY: Not assigned. There are no adequate data on the developmental risks associated
with use of this drug in pregnant women; based on animal data, this drug may cause fetal harm.
 PRECAUTIONS: Do not stop using pramipexole suddenly, or you could have unpleasant
withdrawal symptoms. Follow your doctor's instructions about tapering your dose.
 STD.DOSE: Initial dose: 0.375 mg orally once a day
Titration: Increase gradually no more frequently than every 5 to 7 days, first dose increase should be
to 0.75 mg once a day followed by incremental increases of 0.75 mg; assess therapeutic response and
tolerability at a minimum of 5 days after each dose increase.
Maximum dose: 4.5 mg per day
TB. PRAMIPRO BD 0.75MG(D2+)
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15.  GENERIC: Sodium Bicarbonate
 CATEGORY: Systemic alkaliser
 MOA: Dissociates to provide bicarbonate ion which neutralizes hydrogen ion concentration and
raises blood and urinary pH
 INDICATIONS: Heartburn, indigestion, constipation, GERD,Metabolic acidosis,
Hyperkalemia
 CONTRAINDICATIONS: Alkalosis, hypernatremia, severe pulmonary edema, hypocalcemia,
unknown abdominal pain
 ADVERSE EVENTS: Frequent urge to urinate, headache (continuing)loss of appetite
(continuing)mood or mental changes, muscle pain or twitching, nausea or vomiting,
nervousness or restlessness, slow breathing, swelling of feet or lower legs, unpleasant taste,
unusual tiredness or weakness
 PREGNANCY: Not assigned. Do not use this medicine without a doctor's advice if you
are pregnant.
 PRECAUTIONS: Ask a doctor or pharmacist before taking sodium bicarbonate if you are on a
low-salt diet, or if you have high blood pressure.
 STD. DOSE: For urinary alkalinization: 325 to 2000 mg orally 1 to 4 times a day. One gram
provides 11.9 mEq (mmoL) each of sodium and bicarbonate
TB. SOBISIS FORTE 1G OD(D1-D2)
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16.  GENERIC: Tamsulosin
 CATEGORY: alpha adrenergic antagoinist
 MOA: Tamsulosin is an antagonist of alpha1A-adrenoreceptors in the prostate. Smooth muscle
tone in the prostate is mediated by alpha1A-adrenoreceptors; blocking them leads to relaxation of
smooth muscle in the bladder neck and prostate causing an improvement of urine flow and
decreased symptoms of BPH
 INDICATIONS: BPH, Chronic prostatis, ureteral caliculi expulsion, ureteral stent related urinary
symptoms
 CONTRAINDICATIONS: Concomitant use with strong CYP3A4 inhibitors (including
ketoconazole), hypersensitivity
 ADVERSE EVENTS: difficulty in urination, hypotension, rhinitis, nasal congestion,fever,
drowsiness
 PREGNANCY: tamsulosin is not FDA approved for use in women or children
 PRECAUTIONS: Your blood pressure will need to be checked often. You will also need to be
checked for prostate cancer before and during treatment with tamsulosin.
 STD. DOSE: Initial and Maintenance: 0.4 mg once daily. If response is inadequate after 2 to 4
weeks, may increase to 0.8 mg once daily. If therapy is discontinued or interrupted for several days,
restart with 0.4 mg once daily. Max Dose; 0.8mg
CAP. URIMAX 0.4MG OD(D1-D2)
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17.  GENERIC: Tolvaptan
 CATEGORY: Antidiuretic
 MOA: An arginine vasopressin (AVP) receptor antagonist with affinity for AVP receptor subtypes
V2 and V1a in a ratio of 29:1. Antagonism of the V2 receptor by tolvaptan promotes the excretion of
free water (without loss of serum electrolytes) resulting in net fluid loss, increased urine output,
decreased urine osmolality, and subsequent restoration of normal serum sodium levels.
 INDICATIONS: Autosomal dominant polycystic kidney disease, Hypervolemic or
euvolemic hyponatremia
 CONTRAINDICATIONS: Hypersensitivity, atients with a history, signs, or symptoms of
significant liver impairment or injury
 ADVERSE EVENTS: polyuria, increased thirst, pollakiuria, and xerostomia. Other side effects
include: constipation, fever, hyperglycemia, increased serum alanine aminotransferase, and anorexia.
 PREGNANCY: US FDA pregnancy category C
 PRECAUTIONS: Grapefruit juice may increase tolvaptan serum concentrations. Management:
Avoid concurrent use with grapefruit juice
 STD. DOSE: Initial: 15 mg once daily; after at least 24 hours, may increase to 30 mg once daily to a
maximum of 60 mg once daily titrating at 24-hour intervals to desired serum sodium concentration.
Avoid fluid restriction during the first 24 hours of therapy. Do not use for more than 30 days due to
the risk of hepatotoxicity.
TB. HYPONAT –O 15MG OD(D2+)
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18.  GENERIC: Piracetam
 CATEGORY: Central sstimulant
 MOA: Piracetam is a positive allosteric modulator of the AMPA receptor, Piracetam
may exert its global effect on brain neurotransmission via modulation of ion
channels (i.e., Na+, K+).
 INDICATIONS: Cortical myoclonus, Cognitive enhancer, Dementia, Alzheimer's
disease, Dyslexia
 CONTRAINDICATIONS: Hepatic impairment, Severe renal impairment,
Pregnancy, lactation, Hemorrhagic diathesis
 ADVERSE EVENTS: Blood dyscrasia, renal impairment, impair abilities to drive or
perform hazardous tasks.
 PREGNANCY: This medicine is not recommended for use by pregnant women
unless absolutely necessary and the benefits outweigh the risk associated.
 PRECAUTIONS: The use of this medicine should not be discontinued abruptly as
some patients may feel symptoms of withdrawal.
 STD. DOSE: Adult: 1.6-9.6 g/day orally
TB. NOOTROPIL BD(D2+)
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19.  GENERIC: Levo-carnitine, Coenzyme Q10, L-Arginine, Vitamin E, Lycopene,
Methylcobalamin, Zinc, and Selenium as active ingredients
 CATEGORY: nutritional supplement
 MOA: It controls the levels of levocarnitine, in patients who suffer from problems with
metabolism.
 INDICATIONS: Nutritional deficiencies. It is used therapeutically to stimulate gastric and
pancreatic secretions and in the treatment of hyperlipoproteinemias.
 CONTRAINDICATIONS: Hypersensitivity
 ADVERSE EVENTS: Fever, seizures, arrhythymias, cramp in the stomach and abdomen,
nausea, headache, and diarrhea.
 PREGNANCY: This medication is extremely unsafe to be used during pregnancy. Studies
carried out on humans and animals have shown significant adverse effects on the fetus. Doctor
consultation is recommended in such cases.
 PRECAUTIONS: This medication may cause excessive drowsiness and calmness with alcohol.
 STD. DOSE: 1 tablet per day. Missed dose should be taken as soon as possible. It is
recommended to skip your missed dose, if it is the time for your next scheduled dose.
TB.COMPLETE DT(D2+)
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20.  GENERIC: Selegiline
 CATEGORY: Anti parkinsonian
 MOA: At lower doses, selegiline can serve as a selective inhibitor of MAO-B; however, as selegiline concentrations
increase, MAO-B selectivity is lost. Selegiline may increase dopaminergic activity by interfering with dopamine
reuptake at the synapse. Effects may also be mediated through its metabolites, including amphetamine and
methamphetamine, which interfere with neuronal uptake and enhance release of several neurotransmitters
 INDICATIONS: Parkinson’s Disease, Major Depressive Disorder, ADHD
 CONTRAINDICATIONS: hypersensitivity, Concomitant use of methadone, other MAO inhibitors (selective or
non-selective), propoxyphene, or tramadol within 14 days of selegiline; concomitant use with cyclobenzaprine,
dextromethorphan, or St John’s wort
 ADVERSE EVENTS: application site reaction, dizziness, insomnia, and nausea. Other side effects
include: abdominal pain, skin rash, weight loss, and orthostatic hypotension.
 PREGNANCY: US FDA pregnancy category C
 PRECAUTIONS: Avoid or limit tyramine-containing foods/beverages (product and/or dose-dependent). Some
examples include aged or matured cheese, air-dried or cured meats (including sausages and salamis), fava or broad
bean pods, tap/draft beers, Marmite concentrate, sauerkraut, soy sauce and other soybean condiments. Food’s
freshness is also an important concern; improperly stored or spoiled food can create an environment where tyramine
concentrations may increase
 STD. DOSE: Oral tablet:
Recommended dose: 5 mg orally twice a day
Maximum dose: 10 mg orally per day
TB. SELGIN 5MG BD(D1-D2)
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21.  GENERIC: Rosuvastatin
 CATEGORY: Antihyperlipidemic
 MOA: Inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, the rate-
limiting enzyme in cholesterol synthesis (reduces the production of mevalonic acid from HMG-
CoA); this then results in a compensatory increase in the expression of LDL receptors on
hepatocyte membranes and a stimulation of LDL catabolism.
 INDICATIONS: hyperlipidemias, hyperlipoproteinemia, CV risk prevention, Atherosclerosis,
 CONTRAINDICATIONS: Hypersensitivity to rosuvastatin or any component of the
formulation; active liver disease; unexplained persistent elevations of serum transaminases;
pregnancy; breastfeeding
 ADVERSE EVENTS: myalgia, asthenia, tender swollen glands in neck.
 PREGNANCY: US FDA pregnancy category: X
 PRECAUTIONS: Seek urgent medical advice and consider temporarily withholding
rosuvastatin if you develop any acute muscle pain or have another condition that may increase
your risk of serious muscle injury or kidney failure such as a severe infection, major surgery,
trauma, uncontrolled seizures, severe electrolyte or metabolic disorders.
 STD. DOSE: Initial dose: 10 mg to 20 mg orally once a day
Maintenance dose: 5 mg to 40 mg orally once a day
TB. NOVASTAT 10MG OD(D2+)
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22.  GENERIC: Univestin, Glucosamine sulfate, Chondroitin, MSM and
Vitamin D3 as active ingredients
 MOA: A natural formulation with anti-inflammatory and chondroprotective
properties
 INDICATIONS: Bone, cartilage and joint disorders
 STD. DOSE: - As directed by the physician.
Key benefits/Uses of Trivestin:
- Glucosamine is a nutritional supplement and is used in the treatment of osteoarthritis and rheumatoid arthritis.
- Glucosamine stimulates the production of cartilage, which leads to joint repair. It also maintains elasticity, strength, and
resiliency of the cartilage in movable joints.
- Vitamin D helps the body to use more of the calcium found in foods and supplements.
- Univestin inhibits the enzymes responsible for inflammation thereby reducing joint discomfort and rigidity. It also
improves flexibility and physical function.
- Chondritin works with glucosamine to treat Osteoarthritis.
- Formulation repairs and restores cartilage, bones, and joints.
TB. TRIVESTIN BD(D2+)
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PATIENT NAME: XYZ HOSP. NO:
AGE: yr WEIGHT: kg
SEX: M/F:Male
DATE OF ADMISSION: 11 /02/18
DATE OF DISCHARGE: 14/02/18
COMPLAINTS ON ADMISSION :

MEDICAL HISTORY :
MEDICATION HISTORY : -
SOCIAL HISTORY:
FAMILY HISTORY: NS
PREVIOUS ALLERGIES: N/S
PHYSICAL EXAMINATION: moderately build and nourished, conscious and co-
operative
GENERAL - no P I C C L E
VITAL SIGNS - PR: 90 /min ; BP : 110/80mmhg, R.R:- N/A,
HEENT - N/S
CVS - S1 S2 heard; no murmurs
RS - N/S
GIT - N/S
GU - N/S
EXT - reflexes were normal.
CNS - conscious and oriented
PROVISIONAL DIAGNOSIS:
ROUTINE BIOCHEMICAL INVESTIGATIONS HAEMATOLOGY:
Urea: mg/dl
S.Cr :mg/dl
Na: mEq/L
K: mEq/L
FBS:
PPBS:
RBS:
Tch :
TGs :
T Bili:
D Bili:
T. Prot:
Alb
:
Glo
b:
AS
T:
AL
T:
AL
P:
RBC : Retics:
WBC: Hb:
N: PCV:
L: MCV:
M: MCH:
E: MCHC:
B: ESR:
Platelets:.
URINE ANALYSIS OTHERS
pH: WBC:
Protein RBC:
Sugars: EP.
Blood: Casts:
Crystals:
Stool –
ECG -
FINAL DIAGNOSIS:- Acute wall MI
DRUG WITH DOSE & ROUTE
DURATION OF THERAPY
GENERIC NAME BRAND NAME
1
2
3
4
5
6
7
8
9
8
8
√ √ √ √
√
√ √ √ √
√ √ √ √
√
DISCHARGE MEDICATIONS:
DISCHARGE MEDICATIONS:
Patient not discharged
DAY INVESTIGATIONS
D1
D2
D3
PR – beats/min
BP – mmHg
PR – 80 beats/min
BP – mmHg
PR – 86 beats/min
BP – 100/80 mmHg
REVIEW:
Visit after 1 week
DRUG TREATMENT CHART: PROGRESS CHART:
Medication Dose and
duration
1 2 3 4 5

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PATIENT NAME: XYZ HOSP. NO:
AGE: yr WEIGHT: kg SEX:
M/F:Male
DATE OF ADMISSION: 11 /02/18
DATE OF DISCHARGE: 14/02/18
COMPLAINTS ON ADMISSION :

MEDICAL HISTORY :
MEDICATION HISTORY : -
SOCIAL HISTORY:
FAMILY HISTORY: NS
PREVIOUS ALLERGIES: N/S
PHYSICAL EXAMINATION: moderately build and nourished, conscious and co-operative
GENERAL - no P I C C L E
VITAL SIGNS - PR: 90 /min ; BP : 110/80mmhg, R.R:- N/A,
HEENT - N/S
CVS - S1 S2 heard; no murmurs
RS - N/S
GIT - N/S
GU - N/S
EXT - reflexes were normal.
CNS - conscious and oriented
PROVISIONAL DIAGNOSIS:
ROUTINE BIOCHEMICAL INVESTIGATIONS HAEMATOLOGY:
Urea: mg/dl
S.Cr :mg/dl
Na: mEq/L
K: mEq/L
FBS:
PPBS:
RBS:
Tch :
TGs :
T Bili:
D Bili:
T. Prot:
Alb:
Glo
b:
AST
:
ALT
:
ALP
:
RBC : Retics:
WBC: Hb:
N: PCV:
L: MCV:
M: MCH:
E: MCHC:
B: ESR:
Platelets:.
URINE ANALYSIS OTHERS
pH: WBC:
Protein RBC:
Sugars: EP.
Blood: Casts:
Crystals:
Stool –
ECG -
FINAL DIAGNOSIS:- Acute wall MI
DRUG WITH DOSE & ROUTE
DURATION OF THERAPY
GENERIC NAME BRAND NAME
1
2
3
4
5
6
7
8
9
8
8
√ √ √ √
√
√ √ √ √
√ √ √ √
√
DISCHARGE MEDICATIONS:
DISCHARGE MEDICATIONS:
Patient not discharged
DAY INVESTIGATIONS
D1
D2
D3
PR – beats/min
BP – mmHg
PR – 80 beats/min
BP – mmHg
PR – 86 beats/min
BP – 100/80 mmHg
REVIEW:
Visit after 1 week
DRUG TREATMENT CHART: PROGRESS CHART:
Medication Dose and
duration
1 2 3 4 5

27. PLANNING
 THERAPEUTIC MONITORING:
 TOXICITY MONITORING:
 DISCHARGE MONITORING:
 DISCHARGE MEDICATIONS:
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28. POINT TO PATIENT
 About the disease:
 About lifestyle modifications:
 About medications:
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29. POINT TO PHYSICIAN
 When used as an adjunct to levodopa/carbidopa in the treatment of Parkinson's disease,
selegiline may enhance levodopa-associated side effects in some patients. The presumed
mechanism is enhanced peripheral catecholamine availability due to decreased
degradation (MAOI activity) and increased synthesis (levodopa effect) of dopamine and,
probably, norepinephrine.. MANAGEMENT: Two to three days after adding selegiline
to the regimen, the levodopa/carbidopa dosage may require reduction by 10% to 30%. It
has been suggested that the dosage reduction should be gradual in increments of 10%
every 3 to 4 days and concurrent use should be avoided in patients with postural
hypotension.
 ADJUST DOSING INTERVAL: The oral bioavailability and pharmacologic effects of
levodopa and carbidopa may be decreased during concurrent administration with iron-
containing products..
 The hypotensive effects of levodopa and antihypertensive agents may be additive.
Postural hypotension may occur.. MANAGEMENT: Hemodynamic responses should
be monitored during coadministration, especially during the first few weeks of therapy.
Dose adjustments of the antihypertensive agent may be required.
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30. POINT TO PHYSICIAN
 ADJUST DOSE: Pramipexole may potentiate the dopaminergic side effects of levodopa,
resulting in development or exacerbation of dyskinesia
 SODIUM BICARBONATE AND ROSUVASTATIN: ADJUST DOSING INTERVAL:
Coadministration with antacids or agents with acid-neutralizing effects may reduce the
oral bioavailability of rosuvastatin. The mechanism of interaction has not been
established but may involve a pH-dependent reduction in drug dissolution and
absorption.
 MONITOR: Monoamine oxidase inhibitors (MAOIs) may potentiate the hypotensive
effect of some medications. MAOIs alone quite commonly produce orthostatic
hypotension. Close monitoring for development of hypotension is recommended.
Ambulatory patients should be advised to avoid rising abruptly from a sitting or
recumbent position and to notify their physician if they experience dizziness,
lightheadedness, syncope, orthostasis, or tachycardia.
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31. POINT TO PHYSICIAN
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32.  GENERIC:
 MOA:
 INDICATIONS:
 CONTRAINDICATIONS:
 ADVERSE EVENTS:
 PREGNANCY:
 PRECAUTIONS:
 STD. DOSE:
P D U T I B P H : P A W A S K A R R M
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