24 Feb Harold Broz, a 74-year-old male client (DOB: 9/19/1950), presents with complaints of resting tremors and rigidity that interfere with his daily activities, including dressing and walking

Harold Broz, a 74-year-old male client (DOB: 9/19/1950), presents with complaints of resting tremors and rigidity that interfere with his daily activities, including dressing and walking. He states these symptoms have been occurring over the past year but has recently begun to interfere with his ability to care for himself over the past three months; therefore, he is seeking treatment. The client is awake, alert, and oriented; slowed movement, resting tremors, and rigidity are noted on assessment. The rest of the assessment is unremarkable. Harold is diagnosed with Parkinson’s disease, and first-line medication is considered.  
Past Medical History: High cholesterol, Narrow-angle glaucoma 
Allergies: None
Medications: atorvastatin (Lipitor) 40mg PO daily, Fish Oil, Multivitamin, betaxolol hydrochloride (Betoptic S) 0.5% one drop in each eye BID 
Social History: The client quit smoking thirty years ago and does not drink alcohol. 
Physical Exam:
• Height: 6 feet
• Weight: 192 lbs 
• Body Mass Index (BMI): 26
• Blood Pressure (BP): 110/73
• Heart Rate (HR): 80 
• Respiratory Rate (RR): 19
• Oxygen Saturation (O2 Sat): 97% on RA
• Temperature (TEMP): 98.5 oral
Write an appropriate prescription for this client in the activity below. Click the “Show Answers” option that will appear once all fields are complete to compare your response with the correct answer.

Patient Prescription Transcript
An appropriate prescription for Harold is:
Name: Harold Broz
Date Of Birth: 9/19/1950
Date Prescribed: Current Date
Rx: levodopa 100 mg/carbidopa 10 mg (Sinemet)  
Disp: 7
Sig: Take one tablet by mouth every other day for two weeks. 
Refills (O-4): 0
Dispense as Written:
Generic Substitution Permitted: 
• Either Dispense as Written or Generic Substitution Permitted should be checked on every written prescription depending on what is best for each client.  Refer to the week 1 lesson for criteria.  
Rationale: This client presents with symptoms of Parkinson’s disease. This condition is diagnosed by clinicians based on clinical judgment after assessment. Due to his age and the severity of his motor symptoms, along with a need for substantial improvement in motor function to maintain his independence, he is prescribed dopamine replacement (levodopa/carbidopa [Sinemet]). This treatment choice aims to provide the most effective relief from motor symptoms. The initial dose is one tablet of levodopa 100mg/carbidopa 10mg once every other day. The client should follow up with the provider in just under two weeks, and the provider can then advise the client to take the medication every day if they are not experiencing adverse effects. A new prescription can be issued at that time. The provider must educate the client to monitor for possible side effects, such as dyskinesias and others. The provider should also educate the client that it may take several weeks to months to work, and many medication dosage adjustments and follow-up appointments may be needed, as the dosage is highly individualized (Luu et al., 2021; Pringsheim et al., 2021; Rosenthal & Burchum, 2021).

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