| Multiple-system atrophy and medications: how to minimize the risk of falling. | |
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MedLine Citation:
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PMID: 21402519 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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An 89-year-old female resident in the assisted living section of a continuing care retirement community complained of dizziness and lightheadedness at 10 am daily and was experiencing frequent falls. The facility staff requested a consultant pharmacist perform an extensive review of her medications and medical conditions. Following a chart review and interview with the resident, the consultant pharmacist found that her past medical history consists of coronary artery disease, atrial fibrillation, congestive heart failure, hypertension, dyslipidemia, osteoporosis, gastroesophageal reflux disease, glaucoma, mild dementia, overactive bladder, and Parkinson's disease (PD). The nursing staff monitored the resident's blood pressure during these episodes and determined that the resident was experiencing orthostatic hypotension (OH). During the review, the consultant pharmacist found a recent neurology note that concluded the resident may have multiple-system atrophy (MSA) and her therapy for PD may not be beneficial. As autonomic dysfunction is a common feature of MSA, it is important to minimize the use of medications that can cause or aggravate OH. Additionally, data suggest only a modest and nonsustained response to levodopa in patients with MSA. Therefore, the pharmacist recommended multiple medication changes as well as follow-up monitoring by the patient and assisted living community staff to minimize medication-related problems such as falls. |
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Authors:
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Janet Kohli; Nicole Brandt |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists Volume: 26 ISSN: 0888-5109 ISO Abbreviation: Consult Pharm Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-03-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9013983 Medline TA: Consult Pharm Country: United States |
Other Details:
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Languages: eng Pagination: 190-6 Citation Subset: IM |
Affiliation:
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Omnicare Pharmacy Services, Pittsburgh, Pennsylvania. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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