 |
 |
Chris F. Owen wrote: > I would like to introduce my mother. She just turned 80 > in May and was diagnosed with Parkinson's Disease in 1992. Since > '92, she has deteriorated physically fairly rapidly, losing weight and > having difficulty with mobility and other problems. > She is currently taking Sinamet CR 200/50 @2 1/2 daily; Ritalin > 10 mg. daily; and one aspirin daily. In addition, she is also on heart > medicine lanoxin and novotriamzide(sp?). She's had one eye undergo cat= aract > surgery in April of this year and is scheduled for the other one this f= all. > Her main problems at this time, apart from lack of appetite, ar= e > much dizziness, difficulty with vison, (she can no longer read the > newspaper), and excessive sleepiness, which she finds disconcerting, to > say the least. > She has had a brain scan and there was nothing significant foun= d > and is scheduled to see an ear nose and throat specialist to examine he= r > ears to see if that might be the cause of her dizziness. She has also > seen an eye doctor who determined that there isn't anything significant= ly > wrong with her eyes. > Is there anybody who has either prior experience or knowledge a= nd > can give us any help as to what she can do to alleviate these symptoms?= =20 Dear Chris, I just got back in town to find your messages. I don't have prior=20 experience or knowledge, I am a registered dietitian. But anorexia (loss=20 of appetite), weight loss, and medications that can cause these=20 conditions concern dietitians. I looked up the medications you mentioned, but could find nothing like=20 "novotriamzide"--perhaps it's spelled differently? I checked the other=20 ones, though, with the following results: Ritalin--possible adverse reactions: =95abdominal pain =95agitation =95angina =95anorexia =95anxiety =95arthralgia =95dizziness =95drowsiness =95exfoliative dermatitis =95fever =95headache =95hypertension =95hypotension =95insomnia =95nausea/vomiting =95palpitations =95psychosis =95sinus tachycardia =95urticaria =95vasculitis =95weakness =95weight loss =95withdrawal You mention lack of appetite (Ritalin can cause anorexia), dizziness=20 (dizziness, hypotension), losing weight (weight loss), and I wonder if=20 these symptoms have begun since she started taking Ritalin. Drowsiness=20 can also occur. Drugs that can interact with ritalin: =9Canticholinergics =9Cantihypertensive agents =95bretylium =95caffeine =9Cdiuretics =95dopamine =95epinephrine =9CMAOIs =95phenytoin =9Ctricyclic antidepressants =95warfarin Regarding lanoxin, under "Adverse reactions" I found: =95anorexia =95atrial tachycardia =95AV block =95blurred vision =95confusion =95constipation =95diarrhea =95drowsiness =95fatigue =95gynecomastia =95headache =95hyperkalemia =95hypokalemia =95impotence =95libido decrease =95nausea/vomiting =95photophobia =95PR prolongation =95premature ventricular contractions (PVCs) =95sinus bradycardia =95ST-T wave changes =95syncope =95visual impairment =95xanthopsia I note here the anorexia, blurred vision, drowsiness, and visual=20 impairment--these seem to apply to your mother; there is a note that=20 lanoxin should be used with caution inthe elderly. Under sinemet, the following are listed as=20 contraindications/precautions when taking sinemet: =95cardiac arrhythmias =95cardiac disease =95closed-angle glaucoma =95diabetes mellitus =95hepatic disease =95melanoma =95peptic ulcer disease =95psychosis =95pulmonary disease =95renal disease Possible adverse reactions when taking Sinemet: =95anorexia =95ataxia =95dystonia =95flushing =95hypertension =95hyperventilation =95involuntary movements =95leukopenia =95nausea/vomiting =95neuroleptic malignant syndrome =95orthostatic hypotension =95polyuria =95psychosis =95tremor =95urinary incontinence =95urinary retention =95weight loss Again, we see anorexia, weight loss, with orthostatic hypotension.=20 Unusual tiredness is also possible with sinemet.=20 Chris, older adults often have different reactions to medications than=20 younger people do, as they cannot clear the drugs from their systems as=20 quickly. Her physicians must weigh her condition, age, diagnosis and=20 symptoms against possible side effects, and it's not an easy call. If=20 you think the meds may be taking a toll, I'd discuss it with her=20 doctors. Let me know if this has been of any help. Best regards, --=20 Kathrynne Holden, MS, RD Editor-in-Chief, "Spotlight on Food--nutrition news for people 60-plus" Tel: 970-493-6532 Fax: 970-493-6538=20 http://www.fortnet.org/~fivstar You may wish to contact: Better Business Bureau of the Mountain States, < [log in to unmask]> for further information.