NU 460 Parkinson's Disease Case Study

NU 460 Parkinson's Disease Case Study ► L.C. is a 78-year-old man with a 4-year history of Parkinson's disease (PD). He is a retired engineer, is married, and lives with his wife in a small farming community. He has four adult children who live close by. Since his last visit to the clinic 6 months ago, L.C. reports that his tremors are “about the same” as they were; however, further questioning reveals that he feels his gait is perhaps a little more unsteady, and his fatigue is slightly more noticeable. L.C. is also concerned about increased drooling. Among the medications L.C. takes are carbidopa-levodopa 25/100 mg (Sinemet), one tablet an hour before breakfast and one tablet 2 hours after lunch; carbidopa-levodopa 50/200 mg (Sinemet CR), one tablet at bedtime; and amantadine (Symmetrel) 100 mg at breakfast and bedtime. On the previous visit, he was encouraged to try taking the carbidopa-levodopa (Sinemet) more times throughout the day, but he reports that he became very somnolent with that dosing regimen. He also reports that his dyskinetic movements appear to be worse just after taking his carbidopa-levodopa (Sinemet).