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MComes RPH

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MComes RPH last won the day on March 2

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About MComes RPH

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    Board Certified Pharmacist, Medical Board Member, & Consult
  • Birthday 05/24/1968

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  1. MComes RPH

    Parkinson's Meds Info

    I'm up all the time also. As far as the article, I have posted it before. When I tap on the link of yours it brings up the main page, not the article. I think it is because there should be a back slash / or a from slash\, not a >. Between Gov and article. Thanks for sharing. If you want to fix it and re-post, ill set it up on it's own statement.
  2. MComes RPH

    Requip reduction

    Lou, If they got worse as the dose was increased, then they should lessen as the dose is decreased. The adverse effects are dose related, so they should decrease, and then subside as the dose is stoped (within 24 to 48 hours because of the length of time he was on it). I hope this helps and please keep me posted
  3. MComes RPH

    DESPERATE FOR SCHEDULING HELP

    Linda, I think around midnight would be best. Like I said, try 0.5mg at that time for 2 nights and see how it goes. You can then increase to 1mg after that. We may find that the 0.5mg may work well, but only you can tell. I hope this helps and please keep me posted
  4. MComes RPH

    DESPERATE FOR SCHEDULING HELP

    Linda, I would go for the midnight time frame. I would give 0.5mg at midnight for 2 nights, then increase it to 1 mg there after. Normally I would like to see it more evenly spaced (ie. 9am, 1pm, 6pm, 11pm) during waking hours, but if we can get it to work this way, the coverage may get through the night. I hope this helps and please keep me posted
  5. MComes RPH

    High blood pressure and PD

    S, You are welcome
  6. MComes RPH

    DESPERATE FOR SCHEDULING HELP

    Linda, I think the easiest thing to try would be to add the 4th tablet of Requip to your regime. you would know by morning of the next day if it was successful. If you were to add an XL as the last dose, I'm afraid it may last too long and overlap with the morning dose. There would be some decreasing of the IR and adding the XL if you were to want to use the XL. For now, I think trying the 4th tablet of Requip IR would be your best bet. I hope this helps and please keep me posted.
  7. MComes RPH

    High blood pressure and PD

    S, I would have you track it daily for at least 2 to 3 weeks before requesting any change. At this point I would not stop the Amlodipine entirely, I believe he would probably cut back on the Lisinopril because you are taking a larger amount of it. I believe that he cut back on the Amlodipine to see how your system will react to it. If there is a positive response, which would be a small rise in the diastolic number while the systolic remains the same or close to it, the doctor may leave your meds as they arae at that point. The main isue is to keep track of them at least once a day, twice daily would be better. Also, make sure they are at the same time each day. After 2 to 3 weeks, you could then contact the doctor if you think a change may be in order. I hope this helps and please keep me posted.
  8. MComes RPH

    Interactions

    Gene, There are 2 moderate interactions: 1) Levodopa (Rytary) & Quetiapine: Quetiapine has central antidopaminergic activity and may antagonize the effects of Levodopa, which is a Dopaminergic Agonist. It should be avoided if at all possible. 2) Quetiapine & Nuplazid: The concern is that Quetiapine may have an additive cardiovascular effects in combo with other meds that are known to prolong the QT interval of an electrocardiogram. Coadministration of Quetiapine and other meds that can cause a prolonged QT interval should be avoided is at all possible. I am sure your physician is aware of these to moderate interactions and will take them into consideration if he decides to use Quetiapine. I hope this helps and please keep me posted
  9. MComes RPH

    Requip reduction

    Lou, The half life of Ropinirole is about 6 hours, which means the medication should be out of the system around 12 hours after the last tablet is taken. With him being on it for such a long period of time it may take a little longer. To be on the safe side with his duration of use, we can say for certain it will be completely gone from his system within 24 hours of taking his last dose. I hope this helps and please keep me posted.
  10. MComes RPH

    I'm back after surgery

    Noah, It would truly be a game changer. I guess why I am so happy about this is because it is a new-ish medication and can take up to 4-6 weeks to see improvement. I hope this helps and please keep me posted.
  11. MComes RPH

    hiccups

    Dave, Mary Poppins was correct. It is not completely known as to how it works but one theory is that sugar affects the main nerve, called the Vagus nerve, which connects the brain to the stomach. It is believed that this may stop the diaphragm from spasming. In the most delightful way. I hope this helps and please keep me posted
  12. MComes RPH

    hiccups

    Khanyisile Milner, Hiccups are more common in people with PD than they are to the general population. Continuous hiccups are known as intractable hiccups and can occur in up to 20% of PD patients. The main treatment has been dopamine blocking medications, which would not be good for PD patients. Dr. Ok in, Ask the Doctor forum, suggests having an MRI and focus on the brainstem for intractable hiccups. I hope this helps and please keep me posted
  13. MComes RPH

    I'm back after surgery

    S, I'm sorry if my answer was not very specific, so I will add more detail on this post. The half-life is basically how long a medication lasts in the body before it is half gone. Half-life and how long a medication can work do not always equal the same thing. Usually the longer half life of a medication, the longer it works. It can be different types of medication. With medications like Azilect and Xadago, which are both in the class of MAO-B Inhibitors. How it is metabolized (broken down) can also effect how long the effects of the medication last. Azilect is an irreversible MAO-B Inhibitor. This means that it has effects all day due to this. Xadago is a reversible MAO-B Inhibitor, which means it undergoes a different metabolism. This allows it to last much longer. With Azilect, it may have a half-life of 3 hours, but after it is metabolized those metabolites allow it to work longer. It is somewhat difficult to describe. I hope this helped and, if you still have questions please feel free to ask me.
  14. MComes RPH

    I'm back after surgery

    Noah, It is still in clinical study, Phase 2 I believe. On their website it appears that you are still able to join the study. Just follow this link for more information: http://neuroderm.com/ I hope this helps and keep me posted.
  15. MComes RPH

    Laxatives and Sinemet interaction

    Hello Doc, Dulcolax should be taken 30 to 60 minutes before a meal. So, if the Dulcolax was taken 30 to 60 minutes before eating, then the medication taken 30 to 60 minutes after eating, this should give the best results. Keep in mind it may take 6 to 12 hours for the Dulcolax to work. Another product you may want to look at is Miralax. It used to be prescription, but is now available over-the-counter and also has a less expensive house brand. You can dissolve 1 dose in 8 oz. of water and take it first thing in the morningwith or without food. If any medication needs to be taken in the morning, it should be taken about an hour before taking the Miralax. It dissolves completely in water and has no taste. If you would like, you could add a few drops of concentrated lemon juice to make it more palatable. I hope this helps and please keep me posted
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