Female patient, age 67 years, sick for 9 years.
Disease type: Parkinson's disease.
Previous medical history: chronic coronary heart disease, experience of gas poisoning.
Medications and dosage: Medopa four times a day, half a tablet in the morning, half a tablet at noon, one tablet in the evening, and one tablet at eleven o'clock in the evening; One tablet at morphros at one time, three times a day; Amantadine once a day, one tablet in the afternoon; one tablet in the morning.
At present, the main symptoms: trembling in the right hand, slow walking, pain in the arms, legs and shoulders, severe constipation, and now feel uncomfortable all over the body and cannot sit still.
Want to consult the problem: now recently the patient stomach is not good, sometimes vomiting, after playing the hanging bottle is better, want to consult the vomiting situation is not often taking medicine to hurt the stomach, Rotigotine patch can replace Senforro? The current senforol is 0.25mg, if it can be replaced, how to replace it? Is it better for constipation and stomach after changing? Can I buy it at Qilu Hospital? How can other drugs be adjusted, and recently the physical condition is relatively poor. Thank you Professor Lee.
Professor Li Weiguo answered:
It can be replaced, and if it is replaced, it is also a small dose replacement. Don't completely stop senflora, you can stop half of it first, rotigotin patch you can increase by two milligrams, first with 2 mg, then gradually increase to four milligrams, slowly in the increase. After the symptoms are stabilized, they can be replaced relatively.
She asked whether it is better for constipation and stomach after the change, it is indeed a certain improvement on the stomach, in fact, rotigotine patch is mainly to improve the patient's symptoms of a fluctuation, it absorption is relatively stable, not like oral drugs after having a half-life, after absorption immediately after there are opening about there are peaks and troughs. At present, this medicine cannot be bought from our hospital, and it can be bought in pharmacies outside. You can also buy drugs on behalf of you, unlike some drugs that do not have a batch number imported in China, this is a regular drug, this is no problem.
Because some time ago, the counterfeit drug case made many doctors panic, and some drugs did not dare to recommend casually. In fact, I think this problem is like this, if some drugs are effective, clinicians will still recommend to patients, then rotigotine patch is no problem, it has a domestic quasi-word. How else can other drugs be adjusted? Because in adjusting your current situation, Kodan is OK, but it has a certain impact on liver function. If the entire gastrointestinal tract does not have this condition, I recommend considering surgery again. Because after all, it is getting worse and worse, and now the whole body is uncomfortable, and I can't sit still.
The symptoms of this fluctuation in this case are also so large. After taking so many kinds of drugs, it is still in a situation of gradual aggravation. Then in the middle and late stages, the operation is still put in the first place, in fact, after a certain period of time, there is no need for everyone to avoid surgery.
