RT Book, Section
A1 Chen, Jack J.
A1 Dashtipour, Khashayar
A2 DiPiro, Joseph T.
A2 Talbert, Robert L.
A2 Yee, Gary C.
A2 Matzke, Gary R.
A2 Wells, Barbara G.
A2 Posey, L. Michael
SR Print(0)
ID 1148575161
T1 Parkinson Disease
T2 Pharmacotherapy: A Pathophysiologic Approach, 10e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9781259587481
LK accesspharmacy.mhmedical.com/content.aspx?aid=1148575161
RD 2020/08/03
AB Patient  Care  Process  for  the  Management  of  Parkinson  DiseaseCollectPatient  characteristics  (e.g.,  age,  race,  sex,  hand  dominance)Patient  history  (past  medical,  family,  social—dietary  habits,  alcohol  and  tobacco  use)Motor  and  nonmotor  symptoms  (see  Table  59-1  and  59-2)Current  medications,  prior  medication  use  for  Parkinson  disease  and  response  to  prior  medications  for  Parkinson  disease  (e.g.,  effectiveness,  side  effects),  prior  use  of  dopamine  receptor  blockersObjective  dataheight,  weightLabs  (e.g.,  Scr,  LFT)Other  diagnostic  tests  when  indicated  (e.g.,  neuroimaging)AssessPast  and  current  use  of  medications  associated  with  drug-induced  parkinsonism  (e.g.,  antipsychotics,  metoclopramide,  tetrabenazine)Difficulties  with  performing  activities  of  daily  livingGait  difficulties  and  fall  risk  Motor  or  nonmotor  symptoms  that  are  most  troublesome  for  the  patientAppropriateness,  effectiveness,  and  side  effects  of  current  medications  for  the  motor  and  nonmotor  symptoms  of  Parkinson  diseasePresence  of  motor  complications  (e.g.,  motor  fluctuations,  dyskinesias,  freezing)Plan*Tailored  lifestyle  modifications  (e.g.,  exercise)Drug  therapy  regimen  including  specific  medications  for  Parkinson  disease,  dose,  route,  frequency,  and  duration;  specify  the  continuation  and  discontinuation  of  existing  therapies  (see  Table  59-3)Monitoring  parameters  including  efficacy  (e.g.,  symptom  improvement,  safety  (medication-specific  adverse  effects;  see  Table  59-4),  and  timeframePatient  education  (e.g.,  purpose  of  treatment,  lifestyle  modification,  drug  therapy,  side  effects)Self-monitoring  of  symptoms—where  and  how  to  record  resultsReferrals  to  other  providers  when  appropriate  (e.g.,  physician,  physical  therapy,  speech  therapy)Implement*Provide  patient  education  regarding  all  elements  of  treatment  plan  Use  motivational  interviewing  and  coaching  strategies  to  maximize  adherenceSchedule  follow-upFollow-up:  Monitor  and  EvaluateDetermine  symptom  relief  goal  attainmentPresence  of  adverse  effectsOccurrence  of  motor  complications,  falls,  and  development/progression  of  non-motor  symptomsPatient  adherence  to  treatment  plan  using  multiple  sources  of  information*Collaborate  with  patient,  caregivers,  and  other  health  professionals