Need your help to check APA formatting and assignment proof reading. 2 assignment

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2- You need to read these and check with guidelines for assignment.

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Assignment 1

21/01/2020

Assignment 1

Name:

Reg no:

Parkinson’s disease:……………………………………………………………………………………2

Prescription medication::……………………………………………………………………………2

Medication / drug-drug interaction………………………………………………………………3,4

References……………………………………………………………………………………………5

Table of contents

Parkinson’s disease:

Parkinson’s disease is a neuro de-generative disease that occurs and depletes the neurons present in substansia nigra. These neurons are involved in the transmission of nerve impulses from corpus collosum to the susbtansia nigra part of the mid brain. These are the character playing neurons in managing voluntary motor movements in the body.

It mostly occurs in elderly patients describe by involuntary movements and multi-dimensional brain functioning. The part of this disease may occur due to the effective and excessive use of medications indulging in bi polar or Alzheimer’s disease. The decline of dopamine in par compacta deteriorates the normal functioning of the brain in controlling motor activities.

Prescription medication:

The prescribed medications used for Parkinson’s disease includes the use of Levodopa directly with replenishes the pool for dopamine neurotransmitter.

This drug can’t be given in a single dose rather without carbidopa (LODOSYN) the levodopa will break down into dopamine and then to epinephrine in the body’s periphery. This will create severe symptomatic side effects like an increase in heart rate and sympathetic system dominancy. Dopa-decarboxylase enzyme breaks down the levodopa in the periphery so along with levodopa carbidopa is given. This inhibits the dopa-decarboxylase enzyme and allows levodopa to travel into the blood brain barrier easily.

For the calculations of drug regimen there must be precautionary measures for kidney and liver sensitive enzyme dependent patients. LFT and RFT’s for sensitive patients are done to ensure the correct for dose adjustments not lying in range affecting kidneys and liver function.

Agonist of dopamine:

Use of ergot containing drugs like bromocriptine, ropinirole (Requip), and containing pramipexole (Mirapex). Use for the patch medication there are some drugs given in patch because elder patients sometimes can’t swallow capsules or tablets may be due to fear so Neupro is given as a patch containing rotigotine in it as active ingredient.

Yet another way to administer medication through injectable which involves Apokyn having apomorphine as an active participate of treatment.

MOA inhibitors:

these are the enzymes that break down the dopamine in the periphery of neuron in synaptic cleft. For observing the action they are blocked by these MOA inhibitors (mono amine oxidase inhibitors) including Zelapar, Eldepryl residing selegiline in it.

COMT inhibitors:

These are the reuptake channels and enzymatic control of dopamine from the synaptic cleft. If they are blocked then there will no uptake of dopamine in the neuron and there will be much more dopamine to perform its function and meet the other synaptic surface of a leading neuron. Comtan containing entacapone is used to replenish dopamine concentration in synaptic cleft and Tasmar as Tolcapone.

Anti-cholinergic:

The use of these mnedications is to control the frequency of tremors and muscles movement which results in the deprivation of energy and loss of nutrients from cells resulting in weakening of muscle.

Cogentin containing benztropine is the chiefly used drug in regimens prescribed by doctors.

Non- prescribed drug treatment:

Many ways are there for those patients who wanted to mend their way in treating of Parkinson disease. Most effective practices are exercise, proper muscle movements and massage therapy, speech and locomotors junction therapy. Some of the occupational therapy sessions with therapist recommendations are beneficial for Parkinsonism.

Use of motivated speeches and psychological sessions will bring patients from holding the strong grip over their disease and will think less about it.

Adverse effects and drug –drug interaction:

Most probably the use of drugs for one ailment may cause damage to other parts of the body if it left unaware or unattended. Especially in the case of depression therapy and medication, some of the drugs are related to the origin of Parkinson disease. Alzheimer’s is a psychotic disorder that may lead to Parkinsonism symptoms during its treatment.

Dementia and sleeplessness are the most effective adverse effects of drugs used in Parkinson’s disease. Hallucinations and delusions are also common as these drugs are used as adjunct therapy for depression.

Warfarin has a severe drug-drug interaction with ropinirole and this causes an anticoagulant effect in the blood which forms less solubility of drug and interaction mode of the drug in serum plasma is decreased. Medications use for liver functioning and kidney assistance like thiazide diuretics and loop diuretic used in hypertensive patients will get affected by ropinirole. Gastric drugs for ulcerations and bleeding in the small intestine may be enhanced by the use of levodopa. It will bind to complexes formed by aluminum hydroxide in gastric track thus inhibits the efficacy of the drug and formulate ulceration.

Pediatrics and geriatrics:

Use of a controlled amount of drug regimens in the clinical setup there must be an important note for breast feeding mothers to restrict the required dose for Parkinson’s disease. Related to pediatrics calculated initiated amount of dosage regimen is selected. As ropinirole has severe dementia effect in children. In children, sudden mood swings and motor impartment during exercise and running is seen. But improved therapy sessions have presented the group of medications in one role. Rather put elder patients in that category that deals with the slow and shaking movement of facial muscles and hands, pill rolling movement and improved muscle rigidity is seen. Geriatrics has an affective therapeutic goal in improving dopamine level in the body.

References:

Ahlskog, J. E. (2018, March 1). Aerobic Exercise: Evidence for a Direct Brain Effect to Slow Parkinson Disease Progression. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0025619617308984

Bair, J. D., & Oppelt, T. F. (2001, October). Warfarin and ropinirole interaction. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/11675845

Katzenschlager, R., Poewe, W., Rascol, O., Trenkwalder, C., Deuschl, G., Chaudhuri, K. R., … Lees, A. (2018, July 25). Apomorphine subcutaneous infusion in patients with Parkinson’s disease with persistent motor fluctuations (TOLEDO): a multicentre, double-blind, randomized, placebo-controlled trial. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S1474442218302394

Parkinson’s disease: Parkinson’s: Non-drug treatment. (2019, July 4). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK293718/

Assignment2

21/01/2020

Assignment 2

Name:

Reg no:

Introduction:………………………………………………………………………………………….1 Pharmacodynamics and pharmacokinetic properties………………………………………….….2,3 Disease state:………………………………………………………………………………………..….4 Currently available therapies.…………………………………………………………….………..5 Monitoring parameters.…………………………………………………………….……………….6,7 Personal prescription: .…………………………………………………………….…………………7 References .…………………………………………………………….……………………………..8

Table of contents

FDA Approved drug in recent year

Dayvigo

(lemborexant) (12/20/2019)

Introduction:

In recent years the brain disorders have affected a large number of people over the globe. This turning into the fashion of every single being to overcome productivity and tried to acquire sleep. Sleep disorders are the most prevailing under this category, this helps in bringing the health and life span towards betterment despite warning future depictions. With the introduction of a new medication in treating insomnia and other sleep-related disorders, there must some intervention which helps in manufacturing a structured framework to indulge effective drug regimens and combinations. Experimental trial and judgmental predictions are the true yield for the growing population.

Recent years have diagnosed the most irritating disease these days which tendered the process of the normal sleep cycle.

Pharmacodynamics:

The arousal and wakefulness are determined by the part of the hypothalamus in the brain. This depicts the maintenance of sleep function and its cycle, on the other hand, it demonstrates the appetite and wakefulness. There are hypocretin proteins in the brain which are in the range from 10,000 to 25,000 neurons in the brain. Thus the functioning of a sleep cycle zone is carefully maintained. Lemborexant (Dayvigo) is now determined after the clinical trials that it works by binding to one of the two receptors of hypocretin in the brain. This increases the arousal and appetite requirement in the body. And tends to cause sleep occurrence.

· In another way, it may directly bind to the receptors in the brain after passing through the CNS into neurons of the hypothalamus. Due to high lipoprotein functional groups and bioavailability in blood serum, it can easily pass from the blood-brain barrier. Orexin receptors in the brain are working antagonism to the sleep cycle thus they are antagonized by Dayvigo when administered.

· There are two types of receptors of orexin OX1 and OX2, both of them are blocked by the dual blocking ability of Dayvigo. Due to this dual antagonism function justification for ground reality sleep cycle is beginning.

· Related to recent research some of the familiar drugs may cause severe adverse effects due to single antagonism either of OX1 or OX2.

In this, the hypocretin refers to the embedded genes st4rucutre and the functioning in order to transcript the usual sleep cycle for normal physiology. Disturbance in the peptide chain imbalance for orexin is recommended in postsynaptic disorders in the brain.

Arousal and appetite stimulants are much recommended and preferred choice for the determination of good Dayvigo working. It diminishes the time for onset of rapid eye movement which is the latent period for sleep occurrence by antagonizing oxer in receptors found in the hypothalamus directed to control the sleep cycle and appetite.

Pharmacokinetic:

After judging the proper renal functioning and liver metabolic processes Lemborexant is treated under total balanced plasma concentration. The area under the curve shows the experimental property for determining the highest plasma available protein binding and free drug. The more free drug is there more will the penetration for Dayvigo in the blood brain barrier.

Area under the curve:

The area under the curve for time and concentration has set the goal intervention for 0.8 hours to 0.4 hours implementation dosage. In an average weight of patients ranging from 45-60 kg, the division of drug distribution is followed by the affected dosage regimen depending upon the age factor.

The C max for Dayvigo after administration through the oral route is judge by drawing the graph for %age obtained through the curve calculations by integration of log. High fat and other protein content before obtaining the drug will decrease the C max of the drug after its distribution in blood plasma.

After the co-administration with other medications, the use of Dayvigo is depicted to be rendered for another purpose. It may be involved in hypnosis and psychosis either for delusional interventions. Ground realities for experimentations have shown the right administration with anti-depressants in the case of allowing better efficacy and guided results.

Disease state:

In insomnia, the normal sleep cycle referring to the latent sleep period and wakefulness is mismanaged. This brings a graph of decline in the health of fetuses if given to pregnant women, allowing passing through the umbilical cord depositing in the fetus’s brain. As it has much more lipid penetration power so the adverse effects are more dominant.

Dayvigo antagonizes the orexin receptors in the brain present in the hypothalamus. Due to antagonism receptors are restricted to perform the wakefulness and cause insomnia so sleep-waking is also impaired.

Difference between currently available therapies:

The use for currently available therapies is Davigo which held at the same door for the functioning in pharmacokinetic properties. Rather use in adjuncts some of them are used in parallel fashion just to organize and indulge further specification and prevent complications in a disease state.

After randomized clinical trials and other drug interventions, there are several procedures that form the basis in formulary and dosage regimen. Rats were being used for effective drug purpose and other drug differences yielding good results.

Monitoring parameters:

Most of the drug’s adverse effects and safety profiles are under the guideline of the therapeutic window which depicts the clinical efficacy of a drug user for a specific patient. In order to endure the kidney and liver acceptability, there must be an assurance for brain disorders testing.

Dementia and delusions with disorganized sleep patterns may groom into the natural body attaining the highest possible conditions for change. The reason for good plasma albumin binding capacity is to determine oncotic and vessel friction apparatus working properly also in glomerulus so no leaking of proteins occurs normally in urine formation.

Patient age, sex, weight properties are managed and determine carefully. This brings the historic pectoral representation of educated and communicable civilians. According to the WHO sleeping disorders and another brain, malfunctioning is most prevalent which may be due to hypertension and less diet merged with healthy nutrients.

Personal prescription:

If one prescribed these medications for treating insomnia it will be a much better option if used along with muscle relaxant and hypnotic drugs. These hypnotic and sedative drugs will mimic the action of Dayvigo and enhance its functional capability.

· Sticking to Dayvigo only will have no dominant effect yet it also has addictive and dependent properties. So effective monitoring should be done on the patient if given hypnotics like this. Dependency is most common so as to treat insomnia for lifetime therapy but renal compromised patients have to optimize their dosage regimens unless or until their test reports are under restricted supervision. Drug index and casual effects related to drug functions may be shown including delusion, hallucinations, and dizziness. Order for recognizing the need for this drug must be consulted and MRI for functioning on a trial basis.

References:

(n.d.). Retrieved from

https://www.karger.com/Article/Abstract/495045

Espie, & A., C. (2009, December 1). “Stepped Care”: A Health Technology Solution for Delivering

Zweerde, T. van der, Straten, A. van, Effting, M., Kyle, S. D., & Lancee, J. (2018, May 11). Does online insomnia treatment reduce depressive symptoms? A randomized controlled trial in individuals with both insomnia and depressive symptoms: Psychological Medicine. Retrieved from

https://www.cambridge.org/core/journals/psychological-medicine/article/does-online-insomnia-treatment-reduce-depressive-symptoms-a-randomized-controlled-trial-in-individuals-with-both-insomnia-and-depressive-symptoms/15B2A4BBF766C4343BEDF81FBF32611C

Hertenstein, E., Feige, B., Gmeiner, T., Kienzler, C., Spiegelhalder, K., Johann, A., … Baglioni, C. (2018, November 16). Insomnia as a predictor of mental disorders: A systematic review and meta-analysis. Retrieved from

https://www.sciencedirect.com/science/article/abs/pii/S1087079218301138

Chekroud, A. M. (2019, November 1). The Opportunity for Exercise to Improve Population Mental Health. Retrieved from

https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2749170?widget=personalizedcontent&previousarticle=492577

Riemann, D., Nissen, C., Palagini, L., Otte, A., Perlis, M. L., & Spiegelhalder, K. (2015, April 12). The neurobiology, investigation, and treatment of chronic insomnia. Retrieved from

https://www.sciencedirect.com/science/article/abs/pii/S1474442215000216

Ritterband, L. M. (2017, January 1). Effect of a Web-Based Cognitive Behavior Therapy for Insomnia Intervention. Retrieved from

https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2589161

.

Sedov, I. D., Goodman, S. H., & Tomfohr-Madsen, L. M. (2017, March 24). Insomnia Treatment Preferences During Pregnancy. Retrieved from

https://www.sciencedirect.com/science/article/abs/pii/S0884217517300400

Sweetman, A. M., Lack, L. C., Catcheside, P. G., Antic, N. A., Chai-Coetzer, C. L., Smith, S. S., … McEvoy, R. D. (2016, May 6). Developing a successful treatment for co-morbid insomnia and sleep apnoea. Retrieved from

https://www.sciencedirect.com/science/article/abs/pii/S1087079216300107

Matheson, E., & Hainer, B. L. (2017, July 1). Insomnia: Pharmacologic Therapy. Retrieved from https://www.aafp.org/afp/2017/0701/p29.html

Rubic_Print_

Format

Pharmaceutical Treatment Plan 20.0%

5.0%

20.0%

5.0%

Format

5.0%

5.0%

Course Code	Class Code	Assignment Title	Total Points
NUR-635	NUR-635-XO0103XB		Pharmaceutical Treatment Plan	100.0
Criteria	Percentage	Unsatisfactory (0.00%)	Less than Satisfactory (80.00%)	Satisfactory (88.00%)	Good (92.00%)	Excellent (100.00%)	Comments	Points Earned
Content	70.0%
Prescription and Nonprescription Medications	2				5.0%	Explanation of mechanism of action, pharmacologic category, and pharmacotherapeutic interventions for prescription and nonprescription medications is not given.	Explanation of mechanism of action, pharmacologic category, and pharmacotherapeutic interventions for prescription and nonprescription medications is missing relevant information.	Explanation of mechanism of action, pharmacologic category, and pharmacotherapeutic interventions for prescription and nonprescription medications is adequately developed.	Explanation of mechanism of action, pharmacologic category, and pharmacotherapeutic interventions for prescription and nonprescription medications is developed in detail.	Explanation of mechanism of action, pharmacologic category, and pharmacotherapeutic interventions for prescription and nonprescription medications is developed in detail with thoughtful reflection.
Medication Monitoring, Adverse Effects and Drug-Drug Interactions, and Desired Outcomes			20.0%	Explanation of monitoring, significant adverse effects, drug-drug interactions, and desired outcomes is not given.	Explanation of monitoring, significant adverse effects, drug-drug interactions, and desired outcomes is missing relevant information.	Explanation of monitoring, significant adverse effects, drug-drug interactions, and desired outcomes is adequately developed.	Explanation of monitoring, significant adverse effects, drug-drug interactions, and desired outcomes is developed in detail.	Explanation of monitoring, significant adverse effects, drug-drug interactions, and desired outcomes is developed in detail with thoughtful reflection.
A pharmaceutical treatment plan for the disease or condition is not presented.	An incomplete pharmaceutical treatment plan is presented. The treatment plan is not relevant for the disease or condition presented in the paper. The plan does not incorporate considerations for the various populations affected by the condition or disease.	A pharmaceutical treatment plan is presented. Aspects of the treatment plan are unclear; or, the plan does not present the most effective course of pharmaceutical treatment for the disease or condition.	A pharmaceutical treatment plan is presented. The plan presents an effective course of pharmaceutical treatment for the disease or condition. Some detail or evidence is required to demonstrate support for the plan.	A pharmaceutical treatment plan is presented. The plan presents a clear and effective course of pharmaceutical treatment for the disease or condition. Strong detail and evidence are presented that demonstrate support for the plan. The plan illustrates insight into pharmaceutical treatment for the disease or condition.
Required Sources	Sources are not included.	Number of required sources is only partially met.	Number of required sources is met, but sources are outdated or inappropriate.	Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.	Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content.
Organization and Effectiveness
Thesis Development and Purpose	7.0%	Paper lacks any discernible overall purpose or organizing claim.	Thesis is insufficiently developed or vague. Purpose is not clear.	Thesis is apparent and appropriate to purpose.	Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.	Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
Argument Logic and Construction	8.0%	Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.	Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.	Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.	Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.	Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
Mechanics of Writing (includes spelling, punctuation, grammar, language use)	Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.	Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.	Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.	Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.	Writer is clearly in command of standard, written, academic English.
10.0%
Paper Format (Use of appropriate style for the major and assignment)	Template is not used appropriately or documentation format is rarely followed correctly.	Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.	Template is used, and formatting is correct, although some minor errors may be present.	Template is fully used; There are virtually no errors in formatting style.	All format elements are correct.
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)	Sources are not documented.	Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.	Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.	Sources are documented, as appropriate to assignment and style, and format is mostly correct.	Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
Total Weightage	100%

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Format

20.0%

5.0%

20.0%

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Format 10.0%

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Course Code	Class Code	Assignment Title	Total Points
NUR-635	NUR-635-XO0103XB	Benchmark – Approved Drug by the FDA	120.0
Criteria	Percentage	Unsatisfactory (0.00%)	Less than Satisfactory (80.00%)	Satisfactory (88.00%)	Good (92.00%)	Excellent (100.00%)	Comments	Points Earned
Content	70.0%
FDA-Approved Drug (Pharmacodynamics and Pharmacokinetic Properties of the Chosen Drug)(MSN 6.3; PSTM 1.3)			20.0%	Description of is not given. Drug chosen is not FDA-approved; drug approval has not been within the last year.	Explanation of FDA-approved drug is missing relevant information. The pharmacodynamics and pharmacokinetic properties of the chosen drug are incomplete.	Explanation of FDA-approved drug is adequately developed. The pharmacodynamics and pharmacokinetic properties of the chosen drug are generally presented.	Explanation of FDA-approved drug is developed in detail. The pharmacodynamics and pharmacokinetic properties of the chosen drug are presented.	Explanation of FDA-approved drug is developed in detail with thoughtful reflection. The pharmacodynamics and pharmacokinetic properties of the chosen drug are presented in detail.
Disease State for Which Drug Is Prescribed	Explanation of disease state for new medication is not given.	Explanation of disease state is missing relevant information.	Explanation of disease state is adequately developed.	Explanation of disease state is developed in detail.	Explanation of disease state is developed in detail with thoughtful reflection.
Comparison of FDA Drug to Currently Available Therapies	1				5.0%	Comparison of new medication to currently available therapies is missing relevant information.	Comparison of new medication to currently available therapies is presented, but is missing relevant information.	Comparison of new medication to currently available therapies is adequately developed.	Comparison of new medication to currently available therapies is developed in detail.	Comparison of new medication to currently available therapies is thoroughly developed and supported by strong evidence. Overall comparison demonstrates insight.
Potential Risks, Monitoring, and Prescribing Likelihood		10.0%	Explanation of potential risks, monitoring parameters, and whether one would prescribe the recently approved medication is not given.	Explanation of potential risks, monitoring parameters, and whether one would prescribe the recently approved medication is missing relevant information.	Explanation of potential risks, monitoring parameters, and whether one would prescribe the recently approved medication is adequately developed.	Explanation of potential risks, monitoring parameters, and whether one would prescribe the recently approved medication is developed in detail.	Explanation of potential risks, monitoring parameters, and whether one would prescribe the recently approved medication is developed in detail with thoughtful reflection.
Required Sources	Sources are not included.	Number of required sources is only partially met.	Number of required sources is met, but sources are outdated or inappropriate.	Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.	Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content.
Organization and Effectiveness
Thesis Development and Purpose	7.0%	Paper lacks any discernible overall purpose or organizing claim.	Thesis is insufficiently developed or vague. Purpose is not clear.	Thesis is apparent and appropriate to purpose.	Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.	Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
Argument Logic and Construction	8.0%	Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.	Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.	Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.	Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.	Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
Mechanics of Writing (includes spelling, punctuation, grammar, language use	Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.	Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.	Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.	Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.	Writer is clearly in command of standard, written, academic English.
Paper Format (Use of appropriate style for the major and assignment)	Template is not used appropriately or documentation format is rarely followed correctly.	Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.	Template is used, and formatting is correct, although some minor errors may be present.	Template is fully used; There are virtually no errors in formatting style.	All format elements are correct.
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)	Sources are not documented.	Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.	Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.	Sources are documented, as appropriate to assignment and style, and format is mostly correct.	Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
Total Weightage	100%

Choose a drug that has been approved by the FDA within the past year.

Write a 1,000-1,250 word paper in which you:

Describe the drug approved by the FDA. Include the pharmacodynamics and pharmacokinetic properties of the chosen drug.

Provide an overview of the disease state for which the drug is used.

Describe what is different about this agent compared to currently available therapies.

Discuss the potential risks associated with this agent and any monitoring parameters that are necessary.

Decide whether you would personally prescribe this agent or stick with currently available alternatives.

You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the directions in the Student Success Center.

This assignment benchmarks the following competencies:

MS-NUR-ACNP

6.3: Assess the pharmacodynamics and the pharmacokinetic impact of pharmacologic therapies in the treatment of diseases and altered states.

7.3: Prescribe appropriate pharmacologic and nonpharmacologic therapies in the management of illness, disease, or injuries.

Select a disease or condition. For example, sepsis, CAD, HCAP, HAP, hypertension, CHF, atrial fibrillation, depression, Parkinson’s disease, hyperlipidemia, COPD, asthma, and febrile neutropenia.

Write a 750-1,000 word paper discussing prescription and nonprescription medications/therapies for the treatment of the disease. Discuss monitoring and identify significant adverse effects and drug-drug interactions, as well as desired outcomes of the pharmacological agents used in the treatment of the disease. Determine an appropriate pharmaceutical treatment plan for the disease or condition. Incorporate considerations for various populations (geriatrics, pediatrics) depending on the disease you have selected.

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the directions in the Student Success Center.

Submission Ide: 962eb5f9-a6ba-4cd8-a323-6ce5a6172837

86% SIMILARITY SCORE 2   CITATION ITEMS 63   GRAMMAR ISSUES 0   FEEDBACK COMMENT

Internet Source   86%
Institution   0%

Muhammad Aftkhar

Parkinsonism- Pharmaceutical Treatment Plan x

Summary

 1048 Words  

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Running Header: PARKINSON’S DISEASE

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PARKINSON’S DISEASE

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PARKINSON’S DISEASE

MUHAMMAD AFTKHAR

NUR 635 (GCU)

Mar 4th, 2020

Parkinson’s disease

Parkinson’s disease is a neuro de-generative disease that occurs and depletes the neurons

https://www.sciencedirect.com/science/article/abs/pii/S0025619617308984

https://www.sciencedirect.com/science/article/abs/pii/S1474442218302394

https://www.sciencedirect.com/science/article/abs/pii/S1043661818321078

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PARKINSON’S DISEASE

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 Spelling mistake: Neupro  Euro

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 Spelling mistake: Eldepryl  Elderly

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present in substansia nigra. These neurons are involved in the transmission of nerve impulses

from corpus collosum to the substansia nigra part of the mid brain. These are the character

playing neurons in managing voluntary motor movements in the body. It mostly occurs in elderly

patients describe by involuntary movements and multi-dimensional brain functioning. The part

of this disease may occur due to the effective and excessive use of medications indulging in

bipolar or Alzheimer’s disease (Ahlskog, 2018). The decline of dopamine in par compacta

deteriorates the normal functioning of the brain in controlling motor activities.

Prescription medication

The prescribed medications used for Parkinson’s disease includes the use of Levodopa

directly with replenishes the pool for dopamine neurotransmitter. This drug can’t be given in a

single dose rather without carbidopa (LODOSYN) the levodopa will break down into dopamine

and then to epinephrine in the body’s periphery. This will create severe symptomatic side effects

like an increase in heart rate and sympathetic system dominancy. Dopa-decarboxylase enzyme

breaks down the levodopa in the periphery so along with levodopa carbidopa is given. This

inhibits the dopa-decarboxylase enzyme and allows levodopa to travel into the blood brain

barrier easily.

For the calculations of drug regimen there must be precautionary measures for kidney

and liver sensitive enzyme dependent patients. LFT and RFT’s for sensitive patients are done to

ensure the correct for dose adjustments not lying in range affecting kidneys and liver function.

Below are some of the medications for Parkinson’s disease.

a. Agonist of dopamine: – Use of ergot containing drugs like bromocriptine, ropinirole

(Requip) and pramipexole (Mirapex), They are used for the patch medication there are

some drugs given in patch because elder patients sometimes can’t swallow capsules or

tablets may be due to fear so Neupro is given as a patch that contains rotigotine in it as

active ingredient. Yet another way to administer medication through injectable which

involves Apokyn has apomorphine as an active participate of treatment (Xu et.al, 2019).

b. MOA inhibitors: – These are the enzymes that break down the dopamine in the

periphery of neuron in synaptic cleft. For observing the action, they are blocked by these

MOA inhibitors (mono amine oxidase inhibitors) including Zelapar, Eldepryl residing

selegiline in it.

c. COMT inhibitors: – These are the reuptake channels and enzymatic control of dopamine

from the synaptic cleft. If they are blocked, then there will no uptake of dopamine in the

neuron and there will be much more dopamine to perform its function and meet the other

synaptic surface of a leading neuron. Comtan containing entacapone is used to replenish

dopamine concentration in synaptic cleft and Tasmar as Tolcapone.

d. Anti-cholinergic: – The use of these medications is to control the frequency of tremors

and muscles movement which results in the deprivation of energy and loss of nutrients

from cells resulting in weakening of muscle. Cogentin containing benztropine is the

chiefly used drug in regimens prescribed by doctors ( Richardson et.al, 2018) .

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PARKINSON’S DISEASE

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PARKINSON’S DISEASE

medications in one role (Katzenschlager et.al, 2018). Rather put elder patients in that category

that deals with the slow and shaking movement of facial muscles and hands, pill rolling

movement and improved muscle rigidity is seen. Geriatrics has an affective therapeutic goal in

improving dopamine level in the body.

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e. Non- prescribed drug treatment: – Many ways are there for those patients who wanted

to mend their way in treating of Parkinson disease. Most effective practices are exercise,

proper muscle movements and massage therapy, speech and locomotors junction therapy.

Some of the occupational therapy sessions with therapist recommendations are beneficial

for Parkinsonism. Use of motivated speeches and psychological sessions will bring

patients from holding the strong grip over their disease and will think less about it.

Adverse effects and drug –drug interaction

Most probably the use of drugs for one ailment may cause damage to other parts of the

body if it left unaware or unattended. Especially in the case of depression therapy and

medication, some of the drugs are related to the origin of Parkinson disease. Alzheimer’s is a

psychotic disorder that may lead to Parkinsonism symptoms during its treatment. Dementia and

sleeplessness are the most effective adverse effects of drugs used in Parkinson’s disease.

Hallucinations and delusions are also common as these drugs are used as adjunct therapy for

depression ( Katzenschlager et.al, 2018) .

Warfarin has a severe drug-drug interaction with ropinirole, and this causes an

anticoagulant effect in the blood which forms less solubility of drug and interaction mode of the

drug in serum plasma is decreased. Medications use for liver functioning and kidney assistance

like thiazide diuretics and loop diuretic used in hypertensive patients will get affected by

ropinirole. Gastric drugs for ulcerations and bleeding in the small intestine may be enhanced by

the use of levodopa. It will bind to complexes formed by aluminum hydroxide in gastric track

thus inhibits the efficacy of the drug and formulate ulceration.

Pediatrics and geriatrics

Use of a controlled amount of drug regimens in the clinical setup there must be an

important note for breast feeding mothers to restrict the required dose for Parkinson’s disease.

Related to pediatrics calculated initiated amount of dosage regimen is selected. As ropinirole has

severe dementia effect in children. In children, sudden mood swings and motor impartment

during exercise and running is seen. But improved therapy sessions have presented the group of

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PARKINSON’S DISEASE

References

Ahlskog, J. E. (2018, March). Aerobic exercise: evidence for a direct brain effect to slow

Parkinson disease progression. In Mayo Clinic Proceedings (Vol. 93, No. 3, pp. 360-372).

Elsevier. Retrieved from

https://www.sciencedirect .com/science/article/abs/pii/S0025619617308984

Katzenschlager, R., Poewe, W., Rascol, O., Trenkwalder, C., Deuschl, G., Chaudhuri, K. R., …

& Staines, H. (2018). Apomorphine subcutaneous infusion in patients with Parkinson’s disease

with persistent motor fluctuations (TOLEDO): a multicenter, double-blind, randomized, placebo-

controlled trial. The Lancet Neurology, 17(9), 749-759. Retrieved from

https://www.sciencedirect.com/science/article/abs/pii/S1474442218302394

Richardson, K., Fox, C., Maidment, I., Steel, N., Loke, Y. K., Arthur, A., … & Campbell, N. L.

(2018). Anticholinergic drugs and risk of dementia: case-control study. bmj, 361, k1315.

Xu, W., Reith, M. E., Liu-Chen, L. Y., & Kortagere, S. (2019). Biased signaling agonist of

dopamine D3 receptor induces receptor internalization independent of β-arrestin recruitment.

Pharmacological research, 143, 48-57. Retrieved from

https://www.sciencedirect.com/science/article/abs/pii/S1043661818321078