Microsoft word - most recent prescott newsletter.doc
In support of People with Parkinson’s disease and their caregivers
Meetings are held year-round on the third Thursday of the month from 10:00-11:30 am. at the First Evangelical Lutheran Church, 231 W. Smoketree Lane, Prescott, AZ 86301.
Contacts: Kay Bolander Tel: 928 778 2242 Email [email protected]
Alan Richardson Tel: 928 442 1380 Email [email protected]
Thursday June 21, 2012 Newsletter Issue Number 1066
dopamine enzymes groupings each conceivably requiring a slightly different levodopa formulation
to match accurately the brain’s needs. Thanks to the
pharmaceutical industry and FDA we are using just
Is it reasonable to assume that dopamine produced
in the brain from man-made levodopa is equal to
dopamine made by the brain, naturally? The answer
Sinemet was, and still is the Parkinson’s wonder
lies with the Federal Drug Administration.
drug developed in the late 1960’s. There is nothing
available to compare. Its drawback becomes
The FDA makes it their business to ensure the
apparent as the disease progresses causing the brain
safety and uniformity of pharmaceutical products.
to depend more heavily on imported levodopa
This is both a good and bad thing. When patients
resulting in unattractive and sometimes severe
complain that a generic version of any particular
drug appears not to perform as well as the brand
named drug, the FDA is quick to point out that the
Dopamine to your brain is like gasoline to your
active ingredients are identical. That surely is an
automobile. If you try to run a high performance
admission in the case of Sinemet there is only one
motor on low octane fuel, the low octane may work,
formulation of levodopa whether it is sold as a
but the motor will not run well. That is how some
branded product or as a generic. The FDA say any
PD patients feel on the current version of Sinemet.
apparent difference between the brand and generic
It works, but not well or efficiently in the advanced
drug is purely cosmetic affecting the color, shape
and flavor of the drug. The FDA allows generic
manufacturers a small variance in the strength but
What research exists concerning the performance of
no other variations. This leads to the inevitable
various carbidopa/levodopa formulas to match the
conclusion that there is just one version of levodopa
that is supposed to accommodate all PD patients. To
put the question another way, is the man-made
UP Coming Events
formulation of levodopa that results in dopamine, a
August 1st Dr. Anthony Santiago, Director of the
compromise that approximates the needs of the
Muhammad Ali Parkinson Research Center and
majority without truly meeting the needs fully of
Movement Disorders Clinic at Barrow Neurological
any one group. The compelling answer is yes,
Institute in Phoenix, will speak at the Adult Center
because it is an accepted fact each patient reacts
of Prescott, 1280 E. Rosser St., Prescott.
differently when taking Sinemet. Anyone who has
Time: 9:30 am – 11:30 am. A flyer will follow,
given blood to a blood drive knows there are four
and a sign-up sheet will be available at the June 21st
blood types and a further classification to specify
positive and negative blood. This leads to the
Everyone is urged to attend and hear this important
conclusion that there are probably many different
problematic was the crystal ization of the drug that
experience with Neupro® patches (rotigotine)
apparently refrigeration prevented, but the drug also gave patients a sore red spot on their body and the patch was
Thomas Konzem is a Parkinson’s disease patient of
difficult to keep in place. I was not surprised that it was
Prescott Neurologist, John MacKenzie D.O. and
voluntarily withdrawn. However, because I was using the patch when it was withdrawn Dr. Lieberman, director of
Rohit Dhal MD, Movement Disorder Specialist, at
the Muhammad Ali Center, invited me to participate in a
Barrrow Muhammad Ali Parkinson’s Center.
clinical trial using initial y the refrigerated version of the
Thomas Konzem is interviewed by Alan Richardson
first patch, later the new patch that adheres wel to your
Interviewer: Welcome Tom! We real y appreciate your
skin, makes your flesh slightly pink, not red and sore as
wil ingness to speak with us about the Neupro Patch.
before, and the medicinal benefit lasts for me about 18
And, who is better qualified to tel us about the medicinal
Interviewer: What impact does the use of the patch Tom: It’s the least I can do, because as you know I was
have on the other medications you are taking for PD.?
among the fortunate few to receive the patch in a clinical
trial, when so many other people with PD have been
Tom: I stil take one Azilect 1mg every day, and I have
reduced my intake of Carbidopa-Levodopa ER to one
tablet at bedtime. Amantadine 100mg was added due to
Interviewer: Tel us, if you wil , about your early life.
the increase in dyskinesia. The chief advantage of the
Tom: I was born in Huntington Park, a Los Angeles,
patch is its steady flow of medication. I do not get the
suburb, in 1943. So that makes me 68. I was not in the
military and as far as I know was not subject to any toxic
elements, though one of several early jobs was with the
Interviewer: What advice would you give other people
National Forest Service as a Hot Shot firefighter. Also for
a time I was a USPS letter carrier and a California
Tom: If Parkinson’s is not control ed by dopamine type
Highway Patrol Officer before qualifying as a pharmacist,
medications with many on and off fluctuations, the
Neupro patch is a good option. My quality of life has
Interviewer: Fascinating! Have any of your blood
improved considerably with use of the patch. My
Parkinson’s Hoehn and Yahr Staging Scale has improved
to 3.5, meaning I now have only occasional difficulties in
Tom: My uncle died with PD (my father’s brother).
walking and talking and exhibit “facial masking” (loss of
facial expression). The new Neupro patch should be
Interviewer: Tel us about your PD before the patch and
available at the end of July. The original patch was
about the two versions of that are so very different.
expensive. The new patch is likely to be even more so,
Tom: Dr. MacKenzie diagnosed my PD in 2005 and
because of the revisions required by the FDA. Ask your
prescribed every conceivable combination of anti-
insurer if the patch is included in their formulary of
Parkinson medication there is. Some did little for me;
covered drugs. If not, you wil need a letter from your
others gave me unwanted side effects. I was taking
neurologist explaining the benefit you expect from the
caridopa-levodopa 25/100 mg every 2 hours, so when the
first Neupro Patch was authorized by the FDA, I read the
Interviewer: Thanks, Tom, for sharing with us your
reports of its success in Europe and jumped at the idea of
experience with the new Neupro Patch. I just wish more
a patch. It seemed to work, but for less time than the
people would volunteer their time for ongoing clinical
advertised 24 hours. I felt as though I needed a second
trials that bring benefit to the entire Parkinson’s
patch. I was disheartened by the news that the
manufacturer had withdrawn the formulation in the US.
There were many issues with the first patch. The most
Cycle Statistics Over 11 cycles Ovulation Luteal Phase Cycle Length Average 13 Minimum 11 Maximum 15 Chart Legend: Basal Body Temperature Curve: The temperature plot represents each data point by a small dot. Each dot islinked to the previous one by a line. detected automatically basedon your data or set by one ofchart where the data may be lessaccurate. DPO Count:After o
Lucile Packard Children’s Hospital Clinical Protocol: Revised January 16, 2007 Post-Transplant Primary Immunosuppression Protocol 1) Induction Agents a) Patients with low sensitization risk (peak PRA < 20%, first transplant). i) These patients will receive Zenapax [dacluzimab], administered as follows: (1) Steroid-Based: Zenapax® dose of 1 mg/kg pre-transplant followed by 1 mg