Jump to content
  • Announcements

    • ForumAdmin

      Frequently Asked Questions - Step by step guides

      Do you need assistance registering, logging in, posting, etc? Please visit the all new Frequently Asked Question Forum for step-by-step guides. Click the link below to access these helpful guides. Frequently Asked Questions
    • ForumAdmin

      Recursos Nuevos en Español

      http://www.parkinson.org/ayuda   http://www.parkinson.org/espanol    
    • ForumAdmin

      Línea de Ayuda 1-800-473-4636

      Línea de Ayuda 1-800-473-4636   ¿Qué es la línea de ayuda 1-800-4PD-INFO (473-4636) de la Fundación Nacional de Parkinson? Es un número de teléfono gratuito que ayuda a las personas con la enfermedad de Parkinson, sus familiares, amigos y profesionales de salud, a solucionar diferentes inquietudes.   La línea de ayuda ofrece: Información actualizada Apoyo emocional Referidos a profesionales de salud Recursos comunitarios Amplia variedad de publicaciones gratis    

MComes RPH

Ask the Pharmacist Moderators
  • Content count

  • Joined

  • Last visited

  • Days Won


MComes RPH last won the day on August 22 2016

MComes RPH had the most liked content!

Community Reputation

183 Excellent


About MComes RPH

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

Profile Information

  • Gender
  1. Pain Meds interaction w/PD Meds

    Stump, I'm glad I could help and if you have anymore question, you know where to find me. Good luck.
  2. Stem cell study will be done on human's next

    Noah, I have this study and several other ones bookmarked, so I will keep you posted.
  3. Pain Meds interaction w/PD Meds

    DmCwolfe, Thank you for your input. Those are all excellent ways to help the body heal.
  4. Pain Meds interaction w/PD Meds

    Stump, I have copied your questions so I can answer each one for you. Since there's a chance I could need surgery in the near term (either a recurrent hernia or some other complication from the prior hernia surgery), I have a related question. I am allergic to most of the opioids I've tried in the past. I got a rash from Percocet and Dilaudid. I hallucinated after just 2-3 days on Viocodin. ANSWER: The rash is definitely an allergy to the Percocet and Dilaudid. The hallucinations you experienced while on Vicodin are more of an adverse effect as opposed to an allergy, and are usually dose related. Usually lowering the strength of the medication will usually avoid this from happening. This is further complicated as I am heterozygous positive for Factor V Leiden. As such the current protocol, at least for something like hernia surgery, is 1 week of daily injections of Lovenox. That contraindicates all of the NSAID options I'm aware of. Tylenol is not particularly effective as a pain reducer for me, and hasn't been since I was a small child. ANSWER: As far as you having the Factor V, the usual protocol is to use Lovonex. Sorry to be the bearer of bad news. My options for pain meds are running thin if I do have the surgery. And last time I was (involuntarily, and due to a screw up by the surgeon) without any pain meds for many hours after the surgery and it was about as bad on pain as it gets. Whether I'm just on the wrong end of that particular bell curve, or the surgery went wrong in some way I don't know about yet I don't know, but the assumption should be that I will need something effective at relieving pain for the first couple days after any surgery. ANSWER: Now there are a class of Medications called COX2 inhibitors (one example is Celebrex. I have seen these used for pain because they have very little effect on thinning the blood. But depending on how severe the Factor V is, it would be completely your Dr.s decision as to use it or not. If I do wind up needing surgery what are my best options? Some kind of antihistamine to go with an opioid? Is there an NSAID that is not also a blood thinner? Can high doses of blood thinning NSAID's moot the need for the Lovenox? You can take an antihistamine, like Benadryl, which may cause drowsiness, but the dose to overcome an allergic reaction to medications would have to be so high, and it probably won't even work due to the different histamine receptors we have. As far as the question "Can NSAIDS moot the need for Lovonox," the answer is, unfortunately "No." Every hospital now has opioid prescribing guidelines they must adhere to. So I think you will see a different type of medication therapy than what you had in the past. I hope this helps and please keep me posted.
  5. Pain Meds interaction w/PD Meds

    Flyingfoxone, Thank you very much for your advice. Nabumatone (brand name is Relafen) is a high powered class is medications known as NSAIDS (Non Steroidal Anti-Inflammatory Drugs). The majority are by prescription only, but there are a few you can purchase over-the-counter. Such as Aspirin, Ibuprofen (Motrin or Advil), and Naproxen (Aleve). Acetaminophen (Tylenol) is known as a non-aspirin pain reliever. The reason is because it can be used to relives fever and headache, but DOES NOT reduce inflammation. I hope this helps and please keep me updated.
  6. Pain Meds interaction w/PD Meds

    Jeff, If you are allergic to the opioid used in most pain meds, which is hydrcodone, then you're allergy stems from codeine. Hydrocodone is just a ramped up version of codeine, so anything in that class will have the same effect. The next best option would be a pain medication called Ultram (generic name is tramadol). Ultram is an opiate, but is a very distant cousin to codeine. Now if you were to add a muscle relaxer, the main concern would be drowsiness. Also, Ultram just works on pain and not inflammation. That is why you should also take ibuprofen (brand names are Motrin or Advil) to help with the swelling, inflammation, and mould pain. The main interaction is between Ultram and selegiline. The interaction is known a "Serotonin Syndrome" which can be serious but is very, very, rare. All of the Physicians, MDS, and Neurologist I have spoken with, none of them has ever had this happen to a patient. I hope this helps and please keep me posted.
  7. Nupro patch vs mirapex

    Absolutely. Keeping active, while you still can, is so very important to keep the symptoms to a minimum. Walking is actually one of the best exercises a person with PD can do. Even doing one step more today than what you did yesterday is progress, that is true with any person at any age.
  8. Hi everyone, I was just emailed by AbbVie Pharmaceuticals concerning a Parkinson's Research Study they are conducting. AbbVie Clinical Pharmacology Research Unit (ACPRU) is currently enrolling people ages 45 to 85 for research studies for people who have been diagnosed with Parkinson's Disease. There is no cost to participate and qualified participants may be eligible to receive compensation of up to $1,500 for study participation. Study staff will determine eligibility based on study criteria. To learn more about the study and to see if you qualify, call 1-800-827-2778 or visit abbviephase1.com. For more information, call: AbbVie Pharmaceuticals 1-800-827-2778 To find more specific information on this study, visit AbbViePhase1.com ***I, Mark Comes, have no ties to AbbVie Pharmaceutical Company with respect to financial relationships, stock entitlements, support for this information, money for this post. This information was sent to me because I am a pharmacist and have signed up to be notified of new medications, research studies, and FDA and DEA information about medications.
  9. Nupro patch vs mirapex

    LAD, Even though your MDS and I think the same way about this study does not necessarily mean you should not try other clinical trial study. You can find other trial studies on this website, Mayo clinic, Parkinson Disease Foundation, Michael J. Fox Foundation, parkinsontrial.ninds.hih.gov, and many more. I am glad you have found a medication that works this well for you. Many PD patients have to try several medications before the can find one that takes care of most of the symptoms. I hope this helps and please keep me posted.
  10. Dyskinesia

    Gardner, I am sorry if I was not clear enough, so here is my check list. 1) Dyskensia is a symptom of PD. 2) Too high of levels of Sinemet can cause Dyskensia in PD patients whether they are "on" or "off." 3) If someone who did not have PD were to take Sinemet, depending on how much they took, could possibly have dyskensia. Because if they are working with notmal levels, the Sinemet would put them over the top and cause dyskensia and other side effects of high dose Sinemet, I hope this helps and please keep posted.
  11. Sorry for the delay

    Otolorin, Thank you for the kind words. This is something I really enjoy.
  12. Nupro patch vs mirapex

    Miracle, I have been asked that question many times and my answer is that not all molecules can be made into a patch form due to their size or molecular orientation. I would love to see all long acting medications, not just PD medications, into a patch form because you would get better patient compliance. Unfortunately, as I stated above, it just can't be done. I hope this helps and please keep me posted.
  13. Nupro patch vs mirapex

    LAD, If it's not broke, don't fix it. Keep me posted.
  14. Amantadine

    Esther, These are side effects of the medication that usually subside the longer a patient is on it. Any time there is the addition or increase in dosage of a medication is the time when most adverse reactions take place. It does take time for the body to become "accustomed" to a new medication or an increase in dosage. This should go away anytime between 1 week and 1 month after starting the medication or increasing the dosage of that medication. If you do not have any improvement after approximately 2 to 3 weeks, I would then contact your physicians. I hope this helps and pleas keep me posted.
  15. Dyskinesia

    Gardener, Dyskenia can be caused by too much Sinemet and it is also an effect of the disease it self. Dyskensia, which is due to the disease can happen when the person has an "off" time or when a patient is "on." Thusly, when it happens when it happens when someone is "on" it is called "on" dyskensia. I hope this helps and please keep me posted.