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

Source: http://apdaarizona.org/wp-content/uploads/newsletters/Newsletter_2012-06-01.pdf

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Microsoft word - primary immunosuppression.doc

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

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