Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at home two weeks ago fracturing his forearm and bumping his head. He states that he was going into the...

Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at home
two weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchen
to make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.
Allergies NKDA Current Medications
Levodopa/Carbidopa (Sinemet®) 25/250mg po TID
Fluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)
Amlodipine 5mg PO once daily
Ketorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeks
Diazepam (Valium) 10mg po at bedtime for sleep
PMH Parkinson’s Disease
Depression
HTN
Insomnia
1. Discuss possible reasons this patient fell.
2. List common side effects of Levodopa/Carbidopa
3. He states that he doesn’t think his antidepressant is working. How will you address his concern?
4. Which of his medications might be causing the insomnia? How could this be addressed?
5. List some general education points regarding sleep hygiene.
6. Do you have any concerns about his pain medication?
7. His wife tells you that he has started having hallucinations. Which medication might be causing this?
Discuss why this happens