[Answered]: Case Study 2: Mrs

Case Study 2: Mrs. Thompson’s Parkinson’s Disease Management Mrs. Thompson is a 72-year-old woman who has been admitted to the hospital due to a recent fall caused by a hypotensive episode. She has a history of Parkinson’s disease (diagnosed 8 years ago) and was recently diagnosed with Parkinson’s disease dementia. She also complains of severe muscle spasms in her legs. Upon admission, her vital signs are: Blood Pressure: 105/65 mmHg (notably lower than her usual readings) Heart Rate: 68 bpm Respiratory Rate: 16 breaths/min Temperature: 37.0°C (98.6°F) Mrs. Thompson’s current medication list includes: Carbidopa/Levodopa 25/100 mg three times daily Pramipexole 0.5 mg three times daily Donepezil 5 mg once daily Baclofen 10 mg three times daily The physician has ordered the following medication changes: Increase Donepezil to 10 mg once daily Add Entacapone 200 mg with each dose of Carbidopa/Levodopa Reduce Pramipexole to 0.25 mg three times daily Questions: Identify the primary purpose of each medication Mrs. Thompson is taking, including the one added. (5 points) Explain the mechanism of action of carbidopa/levodopa in treating Parkinson’s disease. How might this medication contribute to Mrs. Thompson’s hypotension? (6 points) The physician has reduced the dose of pramipexole. Explain the rationale for this decision in relation to Mrs. Thompson’s hypotension, and describe three non-pharmacological interventions that could help manage her orthostatic hypotension. (7 points) Mrs. Thompson reports experiencing “on-off” episodes with her carbidopa/levodopa therapy. Explain what this means and how the addition of entacapone might help manage this issue. (6 points) The nurse notices that Mrs. Thompson becomes very drowsy after taking her baclofen dose, which may increase her fall risk. Explain the pharmacological basis for this side effect and suggest one way to manage it while still addressing her muscle spasms. (6 points)