Parkinson's Disease in the Philippines

Wednesday, October 12, 2011

HEALING OF PARKINSON'S DISEASE THRU MEDICINE (COMT INHIBITORS)

It is a known fact that Parkinson’s disease has no cure. In the early stages of uncomplicated Parkinson’s disease, use of pharmacological agents is still the primary mode of treatment. One of the drugs being used in the treatment of PD is the catechol- O - methyltransferase (COMT) inhibitors like entacapone and tolcapone.

MECHANISM OF ACTION:

COMT INHIBITORS reduce the metabolism of levodopa, extending its plasma half - life and prolonging the action of each levodopa dose. Therapeutic dose of entacapone only acts peripherally and does not alter cerebral COMT activity. It is administered together with each dose of levodopa and is not approved for use in early (uncomplicated) and non- fluctuating PD patients.

SYMPTOMATIC TREATMENT:

Symptomatic treatment of parkinsonism using COMT inhibitors as monotherapy is not applicable hence COMT inhibitors should always be given with levodopa. In some studies done on COMT inhibitors, all trials showed a small benefit in the control of the symptoms of parkinsonism, mostly reflected in the activities of daily living but the results were not consistent.

When the initiation of treatment with levodopa/carbidopa/entacapone was compared to that with levodopa/carbidopa, no difference was found between the two treatment arms as to the prevention of motor fluctuations and dyskinesia. There are no studies available on the symptomatic treatment of non-motor problems.

SAFETY

COMT inhibitors increase levodopa bioavailability, so they can increase the incidence of dopaminergic adverse reactions, including nausea, and cardiovascular and neuropsychiatric complications. Diarrhea and urine discoloration are the most frequently reported non-dopaminergic adverse reactions. The combination with selective MAO-B inhibitors (selegiline) is allowed if the dose of MAO-B inhibitor does not exceed the recommended dose.

ENTACAPONE (COMTAN)

The commercially available preparation of a COMT inhibitor in the Philippines is ENTACAPONE (COMTAN) manufactured by NOVARTIS HEALTHCARE. The indications, dosage, manner of administration, contraindication and special precautions are the following:

INDICATIONS: Adjunct to levodopa/benserazide or levodopa/carbidopa treatment in patients with Parkinson's disease and end-of-dose motor fluctuations, who cannot be stabilized on those combinations.

DOSAGE:

One 200-mg tab with each levodopa or dopa decarboxylase inhibitor dose. Maximum: 2 g/day

ADMINISTRATION:

May be taken with or without meals.

CONTRAINDICATIONS:      Pregnancy and lactation
     Pheochromocytoma
     Concommitant use with nonselective MAO inhibitors (MAO-A and MAO-B) or with a selective MAO-A plus a selective MAO-B inhibitor.
     Liver impairment
     History of neuroleptic malignant syndrome &/or nontraumatic rhabdomyolysis

SPECIAL PRECAUTIONS:     Dosage of L-dopa and other antiparkinsonism drugs(e.g. dopamine agonists) may need to be adjusted.
     L-dopa induced orthostatic hypotension may be aggravated.
     Effects of medicinal products metabolized by catechol-O-methyl transferase may be potentiated.
     Caution when discontinuing treatment, when driving or operating machines due to potential sudden sleep onset episodes.

To get an update in the diagnosis and management of Parkinson's disease, Pinoy Parkinson's Disease or Pinoy PD is holding its First Annual Convention on October 22, 2011 in Makati City.

P.S. FINAL EXTENSION OF FREE REGISTRATION! Register for FREE on or before OCTOBER 15, 2011.

P.P.S. Register for a GUARANTEED SEAT and SLOT in the workshop to a LIMITED NUMBER of participants on or before OCTOBER 15, 2011 including LUNCH, 2 SNACKS and SEMINAR KIT!

P.P.P.S. Submit REGISTRATION DETAILS (Name, Age, Contact number and E-mail address) on or before OCTOBER 15, 2011 to avail of FREE REGISTRATION and send via email to drajoy31@yahoo.com / drajoy31@gmail.com

Pinoy PD Thru G-MEN

View another webinar from Ness Cabahug

Tuesday, October 11, 2011

HEALING OF PARKINSON'S DISEASE THRU GOD'S GOODNESS

St. Francis of Assisi

October 4, 2011 was the Memorial of St. Francis of Assisi. He was the epitome of God's goodness because of how he was converted from a wordly life to that of a religious life.

Saint Francis of Assisi (born Giovanni Francesco di Bernardone; 1181/1182 – October 3, 1226) was an Italian Catholic friar and preacher. He founded the men's Franciscan Order, the women’s Order of St. Clare, and the lay Third Order of Saint Francis. St. Francis is one of the most venerated religious figures in history.

Francis was the son of a wealthy cloth merchant in Assisi, and he lived the high-spirited life typical of a wealthy young man, even fighting as a soldier for Assisi. While going off to war in 1204, Francis had a vision that directed him back to Assisi, where he lost his taste for his worldly life. On a pilgrimage to Rome, Francis begged with the beggars at St. Peter's. The experience moved him to live in poverty. Francis returned home, began preaching on the streets, and soon amassed a following. His order was endorsed by Pope Innocent III in 1210. He then founded the Order of Poor Clares, which was an enclosed order for women, as well as the Third Order of Brothers and Sisters of Penance. In 1219, he went to Egypt where crusaders were besieging Damietta, hoping to find martyrdom at the hands of the Muslims. By this point, the Franciscan Order had grown to such an extent that its primitive organizational structure was no longer sufficient. He returned to Italy to organize the order. Once his organization was endorsed by the Pope, he withdrew increasingly from external affairs. In 1223, Francis arranged for the first Christmas manger scene. In 1224, he received the stigmata, making him the first person to bear the wounds of Christ's Passion. He died in 1226 while singing Psalm 141.

On July 16, 1228, he was pronounced a saint by Pope Gregory IX. He is known as the patron saint of animals, the environment and one of the two patrons of Italy (with Catherine of Siena), and it is customary for Catholic and Anglican churches to hold ceremonies blessing animals on his feast day of 4 October.

References:

http://en.wikipedia.org/wiki/Francis_of_Assisi

SCRIPTURES:

"For you were once darkness, but now you are light in the Lord. Live as children of light, for light produces every kind of goodness and righteousness and truth. Try to learn what is pleasing to the Lord."

Ephesians 5: 8-10

"Whoever walks without blame, doing what is right, speaking truth from the heart; who does not salnder a neighbor, does no harm to another, never defames a friend; who disdains the wicked, but honors those who fear the Lord; who keeps an oath despite the cost, lends no money at interest, accepts no bribe against the innocent. Whoever acts like this shall never be shaken."

Psalms 15: 2-5

" Make known to me your ways, Lord, teach me your paths. Guide me in your truth and teach me, for you are God my savior. For you I wait all the long day, because of your goodness, Lord. Remember your compasiion and love, O Lord; for they are ages old. Remember no more the sins of my youth, remember me only in light of your love. Good and upright is the Lord, who shows sinners the way. Guides the humble rightly, and teaches the humble the way."

Psalms 25: 4-9

"Trust in the Lord and do good that you may dwell in the land and live secure. Find your delight in the Lord who will give you your heart's desire."

Psalms 35: 3-4

"Great is the Lord and worthy of high praise; God's grandeur is beyond understanding. One generation praises your deeds to the next and procliams your mighty works. They speak of the splendor of your majestic glory, tell of your wonderful deeds. They publish the renown of your abounding goodness and joyfully sing of your justice. The Lord is gracious and merciful, slow to anger and abounding in love. The Lord is good to all, compassionate to every creature."

Psalms 145: 3-9

PRAYER:

PRAYER FOR HEALING OF PARKINSON’S DISEASE
THROUGH THE INTERCESSION OF BLESSED JOHN PAUL II

When my legs are frozen in place,
May God the Father push me and remind me
To lift my toes up and swing my arms
That I may walk again and not be afraid.

When I feel like falling or as my posture stoops,
May Jesus Christ, God the Son, break my fall
And catch me as I move forward
With my legs braced and feet wide apart.

When my movement is slow and I hesitate,
May God the Holy Spirit enlighten my path,
Broaden my horizon and show me the way
That I will be more agile and graceful in my steps and bearing.

When my hands and feet are shaking, or my chin trembles,
And my voice weakens as I speak,
May Mother Mary embrace me to calm me and assure me
That everything will be okay and I can rest in her arms and wait
Until everything is still and steady and I am in peace
As my voice grows strong and clear.

Forgive me, God the Father, for all my sins
Heal me, God the Son, from my Parkinson’s disease
Bless me, God the Holy Spirit, with wisdom and knowledge
Love me, Mother Mary, so that I can love and serve others despite my PD.
Thank you, Lord, for granting my prayers.

We ask all these, through the intercession of Blessed John Paul II.
Amen.

Our Father…
Hail Mary…
Glory Be…

Blessed John Paul II, Pray for us.

Prayer For Peace by St. Francis of Assisi

Lord, make me an instrument of your peace.
Where there is hatred, let me sow love.
Where there is injury, pardon,
Where there is doubt, faith,
Where there is despair, hope,
Where there is darkness, light,
and where there is sadness,joy.

O Divine Master, grant that
I may not so much seek
to be consoled as to console;
To be understood as to understand;
To be loved as to love;

For it is in giving that we receive
it is in pardoning that
we are pardoned;
And it is in dying that
we are born to eternal life.

St. Francis of Assiss, pray for us.

ACTION:

Today, I will be like St. Francis in being an instrument of peace to every person I meet. I will also take part in the first annual convention of Pinoy Parkinson's disease on October 22, 2011 in Makati City so I can encourage other Pinoy PD's like myself to to experience God's goodness and mercy.

P.S. FINAL CALL FOR FREE REGISTRATION ! Register for FREE on or before October 15, 2011.

P.P.S. Register for a GUARANTEED SEAT and SLOT in the workshop to a LIMITED NUMBER of participants on or before October 15, 2011, including LUNCH, 2 SNACKS and SEMINAR KIT!

P.P.P.S. Submit REGISTRATION DETAILS (Name, Age, Contact number and E-mail address) on or before October 15, 2011 to avail of FREE REGISTRATION and send via email to drajoy31@yahoo.com / drajoy31@gmail.com

Pinoy PD Thru G-MEN

View another webinar from Ness Cabahug

Saturday, October 8, 2011

How Can A Vegetarian Diet Be Of Help To PD Patients

By Nona Lema

(Last of a 3-part article series)

The amount of protein that the PD patient takes can have a major impact on the symptoms of the disease. So experts say ‘go high-carb, low-protein’ . They say PD patients who are taking levodopa need to limit the amount of proteins they eat. Protein is made up of amino acids, and the amino acids in food interfere with levodopa getting into the brain. (Levodopa is also an amino acid). What better way to lessen protein intake than to adapt a vegetarian diet. For a clear understanding of just how much protein an average person needs, I’m quoting here the whole of Chapter 2 of GULAY cookbook, wherein I discussed in detail about protein.

…Chapter 2 How Much Protein?

In my many years of teaching about the vegetarian diet, the most frequently asked question is, “where do you get your protein?” Oftentimes, people are reluctant to eliminate meat from their diet because they are worried that if they do, they will somehow be protein deficient. There is no need to be worried about protein deficiency. This fear of ‘not getting enough protein’ from vegetable sources is not only unfounded but it actually leads to an even more serious problem. It is how not to get too much! Having too much protein in one’s body is actually as dangerous as not having enough.

In the world today, meat is generally thought to be the ideal source of protein. Quality-wise, quantity-wise. That is why nowadays whenever people say ‘protein’, it is usually associated with meat. We were brought up thinking this way - - an idea widely propagated by major meat companies.

However, we should be asking, is meat really the ONLY source of protein? If we are supposed to have protein, how much is enough? How much is too much? It is very important to know these things so that we don’t become too paranoid about so-called not getting enough.

Actually, the RDA (Recommended Dietary Allowance) of protein for an average adult is only between 40 to 65 grams daily. Our daily needs of protein ranges from only TWO AND A HALF percent of our total daily calories up to about EIGHT percent. So if we look at the percentage of calories from protein based on nutritive values of our local food, we will find that if we eat, for example, an average serving of rice (16% protein) with Ginisang Mongo (29(%), our daily protein requirement is more than fully satisfied. If we eat rice (16%) with Pritong Tokwa (43%) and some tomatoes (18%), our protein needs for the day is easily taken care of. Even if we eat nothing but oatmeal (16%) or camote (8%) or saging na saba (8%) for the day, still we would have more than enough protein for our needs. So here I’m showing you just how low our protein needs really are. And almost all plant food provide protein.

Once the daily requirement is met, the excess protein foes to waste. Consuming more that what the body requires places a heavy burden on our whole system as it tries to rid the body of the excess. Meat is definitely high-protein food. All flesh foods and eggs are considered so because they contain all the essential amino acids. But in fact, meat is so high in protein content that it is no longer necessary. The body cannot absorb that much protein anyway. For example, an average serving of pork chop has about 180-200 grams of protein. That’s far, far more than the daily requirement! Therefore, if we are on a regular meat diet daily, where does this huge amount of excess protein go? It is broken down in the liver and excreted through the kidneys. This causes the liver and the kidneys to work harder. If the liver and the kidneys are overworked, we eventually become ill.

So the point is: don’t worry. First, we simply don’t need as much protein as we have been led to believe. Second, whatever little amount we need, it is abundantly available in the vegetable kingdom in the form of legumes, beans, and many other vegetables. Actually, vegetable protein is not only equal in quantity to meat protein, it is even superior in quality because none of the legumes, seeds, grains, or nuts contain cholesterol and saturated fats. Also, they are nature-packed with vitamins, minerals, fiber and carbohydrates, whereas all flesh foods and eggs are packed with cholesterol and saturated fats. So, we simply have to learn how to combine and balance different vegetable protein foods. By mixing grains, legumes, nuts, and seeds in a meal, it is easy to get an adequate supply of protein containing all eight essential amino acids.

So, to summarize: Protein is an essential nutrient. We cannot just eliminate protein from the PD patients’ diet just because it interferes with levodopa. So what do you do? The solution is to avoid high protein food such as meat and eggs AND make sure the PD patients eat enough protein from vegetable sources.

Grab the chance to meet the author, Ms. Nona Lema, in person, during the First Annual Convention of Pinoy Parkinson's Disease on October 22, 2011 in Makati City.

P.S. FINAL EXTENSION OF FREE REGISTRATION! Register for FREE on or before OCTOBER 15, 2011.

P.P.S. Register for a GUARANTEED SEAT and SLOT in the workshop to a LIMITED NUMBER of participants on or before OCTOBER 15, 2011 with FREE LUNCH, 2 SNACKS and SEMINAR KIT!

P.P.P.S. Submit REGISTRATION DETAILS (Name, Age, Contact number and E-mail address) on or before OCTOBER 15, 2011 to avail of FREE REGISTRATION and send via email to drajoy31@yahoo.com / drajoy31@gmail.com

Pinoy PD Thru G-MEN

View another webinar from Ness Cabahug

HEALING OF PARKINSON'S DISEASE THRU MEDICINE (ANTICHOLINERGICS)

The mechanism of action of anticholinergics is believed be involved in correcting the disequilibrium between striatal dopamine and acetylcholine neurotransmission. Some anticholinergics, e.g. benzotropine, can also block dopamine uptake in central dopaminergic neurons. The anticholinergics used to treat PD specifically block muscarinic receptors. These drugs have only a small effect on PD symptoms, and that evidence for a special effect on tremor is inconclusive. Because of the risk of side effects, centrally acting anticholinergics are usually not advised for the therapy of non - motor, i.e. autonomic, dysfunctions.

The clinical use of anticholinergics has been limited by their side- effect profiles and contraindications. The most commonly reported side effects are blurred vision,urinary retention, nausea, constipation (rarely leading to paralytic ileus), and dry mouth. The incidence of reduced sweating, particularly in those patients on neuroleptics, can lead to fatal heat stroke.

Anticholinergics are contraindicated in patients with narrow-angle glaucoma, tachycardia, hypertrophy of the prostate, gastrointestinal obstruction, and megacolon. Impaired mental function (mainly immediate memory and memory acquisition) and acute confusional state are a well documented central side effect that resolves after drug withdrawal. Therefore, if dementia is present, the use of anticholinergics is contraindicated. The abrupt withdrawal of anticholinergics may lead to a rebound effect with marked deterioration of parkinsonism. Consequently, anticholinergics should be discontinued gradually and with caution.

An anticholinergic preparation which is commercially available in the Philippines is biperiden HCl. The brand names are (AKINETON) by ABBOTT, (AKIDIN) by MED CHOICE PHARMA and (AKETON) by YOO YOUNG. The indications, dosage, manner of administration, contraindications, special precautions, adverse reactions and drug interactions are as follows:

INDICATIONS:
   TAB: Adjunct therapy of all forms of parkinsonism (post-encephalitic, arteriosclerotic and idiopathic)
   AMP: Symptomatic treatment of parkinsonism including the alleviation of the extrapyramidal syndrome induced by drugs

DOSAGE:
   TAB: Adult Parkinsonism : Initially 1 mg BID, increased by 2 mg/day. Maximum: 16 mg daily
        Drug-induced movement disorders : 1-4 mg once-QID
        Children : 3-15 yr 1-2 mg once-TID

ADMINISTRATION: May be taken with or without food

CONTRAINDICATIONS:
     Untreated narrow-angle glaucoma
     Intestinal stenoses or obstruction
     Megacolon
     Prostatic hypertrophy
     Life-threatening tachycardia

SPECIAL PRECAUTIONS:
     Avoid abrupt discontinuation.
     Increased sensitivity to side effects especially elderly.
     Enhanced risk of cerebral seizures in predisposed persons.
     Abuse
     Impaired ability to drive or operate machinery.

ADVERSE REACTIONS:
     Fatigue
     Dizziness
     Drowsiness
     Dry mouth
     Rarely : Swelling of salivary glands
              Accommodation difficulties
              Mydriasis
              Photophobia
              Hypohydrosis
              Constipation
              Gastric symptoms
              Nausea
              Tachycardia
     Very rarely: Bradycardia, especially at higher doses
              Restlessness
              Agitation
              Anxiety
              Confusion
              Euphoria
     Occasionally: Impairment of memory
     In rare cases: Delirium
              Hallucinations
              Nervousness
              Headache
              Insomnia
              Dyskinesia
              Ataxia
              Muscle twitching
              Speech Impairment

DRUG INTERACTIONS:
    Enhanced anticholinergic effects in combination with other psychotropic drugs
    Antihistamines
    Antiparkinsonism drugs
    Antispasmodics
    Quinidine
    Pethidine
    Dyskinesia induced by levodopa may be potentiated
    Effects of alcohol may be enhanced
    Antagonistic influence on the action of metoclopramide and compound of similar activity in the GIT.

To get an update in the diagnosis and management of Parkinson's disease, Pinoy Parkinson's Disease or Pinoy PD is holding its First Annual Convention on October 22, 2011 in Makati City.

P.S. EXTENDED FREE REGISTRATION! Register for FREE on or before OCTOBER 15, 2011.

P.P.S. Register for a GUARANTEED SEAT and SLOT in the workshop to a LIMITED NUMBER of participants on or before OCTOBER 15, 2011 including LUNCH, 2 SNACKS and SEMINAR KIT.

P.P.P.S. Submit REGISTRATION DETAILS (Name, Age, Contact number and E-mail address) on or before OCTOBER 15, 2011 to avail of FREE REGISTRATION and send via email to drajoy31@yahoo.com / drajoy31@gmail.com

Pinoy PD Thru G-MEN

View another webinar from Ness Cabahug

Thursday, September 29, 2011

HEALING OF PARKINSON'S DISEASE THRU MIRACLES AND MIGHTY DEEDS

A diagnosis of Parkinson's disease is based on medical history and a thorough neurological examination. Sometimes a doctor may check your sense of smell. Sometimes, your doctor will have you try a medicine for Parkinson's disease. If that medicine helps your symptoms, it may help the doctor find out if you have Parkinson's disease.There are no lab tests that can diagnose Parkinson's disease and there is no known cure. But Parkinson's disease can affect many aspects of a person's daily life and give him so much reason to despair and give up. However, with careful planning and activity moderation, the effects of Parkinson's can become much less stressful and intrusive. It also entails praying for healing through miracles and mighty deeds.

The miracle of John Paul II: Marie Simon- Pierre

SCRIPTURES:

" When it was evening, they brought him many who were possessed by demons, and he drove out the

spirits by a word and cured all the sick to fulfill what had been said by Isaiah the prophet: "He took away our infirmities and bore our diseases."...

..." A woman suffering hemorrhages for twelve years came up behind him and touched the tassel on is cloak. She said to herself, ' If only I can touch his cloak, I shall be cured.' Jesus turned around and saw he, and said, 'Courage, daughter! Your faith has saved you,' And from that hour the woman was cured."...

..." And as Jesus passed on from there, two blind men followed [him], crying out, 'Son of David, have pity on us!' When he entered the house, the blind men approached him and Jesus said to them, 'Do you beleive that I can do this?' 'Yes, Lord,' they said to him. Then he touched their eyes and said,'Let it be done for you according to your faith.' And their eyes were opened."...

..."Jesus went around to all the towns and villages, teaching in their synagogues, proclaiming the gospel of the kingdom, and curing every disease and illness. At the sight of the crowds, his heart was moved with pity for them because they were troubled and abandoned, like sheep without a shepherd."...

..." Jesus sent out these twelve after instructing them thus, ' Do not go into pagan territory or enter a Smaaritan town. Go rather to the lost sheep of the house of Israel. As you go, make this proclamation: 'The kingdom of heaven is at hand. Cure the sick, raise the dead, cleanse lepers, drive out demons.'"

Matthew 8:16-17; 9:20-22, 27-30,35-36; 10:5-8

PRAYER:

PRAYER FOR HEALING OF PARKINSON’S DISEASE
THROUGH THE INTERCESSION OF BLESSED JOHN PAUL II

When my legs are frozen in place,
May God the Father push me and remind me
To lift my toes up so that I may walk again
And not be afraid.

When I feel like falling or as my posture stoops,
May Jesus Christ, God the Son, break my fall
And catch me as I move forward
With my legs braced and feet wide apart.

When my movement is slow and I hesitate,
May God the Holy Spirit enlighten my path,
Broaden my horizon and show me the way
That I will be more agile and sure in my steps and bearing.

We ask all these, through the intercession of Blessed John Paul II.
Amen.

Our Father…
Hail Mary…
Glory Be…

Blessed John Paul II, Pray for us.

ACTION:

Today I will take that extra step and not be afraid. I will recite the prayer for healing of parkinson's disease 3x a day,i.e., when I wake up in the morning, after my midday meal and before retiring at night. I will register and attend the first convention on Pinoy PD and socialize with other Pinoy PD's so we can share each others joys and sorrows.

P.S. FREE REGISTRATION EXTENDED! Register for FREE on or before October 7, 2011.

P.P.S. Register for a GUARANTEED SEAT and SLOT in the workshop to a LIMITED NUMBER of participants on or before October 7, 2011.

P.P.P.S. Submit REGISTRATION DETAILS (Name, Age, Contact number and E-mail address) on or before October 7, 2011 to avail of FREE REGISTRATION and send via email to drajoy31@yahoo.com / drajoy31@gmail.com

Pinoy PD Thru G-MEN

View another webinar from Ness Cabahug

Tuesday, September 27, 2011

HEALING OF PARKINSON'S DISEASE THRU MEDICINE (DOPAMINE AGONIST)

It is a known fact the Parkinson’s disease or PD has no cure. In the early stages of uncomplicated Parkinson’s disease, the use of pharmacological agents is still the primary mode of treatment and also the most common therapy for PD. Aside from levodopa, dopamine agonists are the other recommended antiparkinson drugs during the early stages of the disease. There are 3 dopamine agonists which are commercially available in the Philippines, namely:

BROMOCRIPTINE MESYLATE

(PARLODEL)
NOVARTIS HEALTHCARE
[ZUELLIG] {P141.50}

PRAMIPEXOLE diHCl
(SIFROL)
BOEHRINGER INGELHEIM
[METRO DRUG]
{P151.00} of 1 mg/tab

PIRIBEDIL
(TRIVASTAL RETARD 50)
SERVIER
[ZUELLIG]
{P38.50}

LEGEND:

GENERIC NAME
(BRAND NAME)
MANUFACTURER
[DISTRIBUTOR]
{SUGGESTED RETAIL PRICE}

However, I will only discuss one of the three dopamine agonists ,PRAMIPEXOLE, which is a non-ergot derivative.

What are the INDICATIONS for the use of pramipexole?

1. Treatment of signs and symptoms of idiopathic Parkinson's disease
2. As monotherapy or in combination with levodopa
3. Symptomatic treatment of idiopathic restless leg syndrome

What is the usual DOSAGE of pramipexole?:

1. Parkinson's disease

Week 1 - 0.125 mg 3x a day
Week 2 - 0.25 mg 3x a day
Week 3 - 0.5 mg 3x a day
Maximum 4.5 mg/day

2. Restless Leg Syndrome

Step 1: 0.125 mg
Step 2: 0.25 mg
Step 3: 0.5 mg
Step 4: 0.75 mg (Maximum dose)
All doses taken once daily 2-3 hours before bedtime. If needed, titrate to each step every 4-7 days.

How do you ADMINISTER oral Pramipexole?

Pramipexole may also be taken with meals to minimize gastrointestinal upset.

What are the SPECIAL PRECAUTIONS in the use of parmipexole?

The dose must be reduced in patients with renal impairment or creatinine clearance (CrCl) of less than 50 ml/min.

What are the ADVERSE REACTIONS of pramipexole? (DiCoFISHPEN)

1. Dizziness
2. Dyskinesia
3. Constipation
4. Confusion
5. Falling asleep during activities of daily living
6. Insomnia
7. Somnolence
8. Hallucination
9. Peripheral edema
10. Nausea

What are the PREPARATIONS of pramipexole?

Pramipexole is available in either 250 mcg/tab or 1 mg/tab.

To learn more about the recent updates in the diagnosis and management of Parkinson's disease, attend the first annual convention of Pinoy PD, entitled: "HEALING OF PARKINSON'S DISEASE THRU G-MEN (GOD, MEDICINE, EXERCISE and NUTRITION).

P.S. Register for FREE on or before September 30, 2011.

P.P.S. Register for a GUARANTEED SEAT and SLOT in the workshop to a LIMITED NUMBER of participants on or before September 30, 2011.

P.P.P.S. Submit REGISTRATION DETAILS (Name, Age, Contact number and E-mail address) on or before September 30, 2011 to avail of FREE REGISTRATION and send via email to drajoy31@yahoo.com / drajoy31@gmail.com

Pinoy PD Thru G-MEN

View another webinar from Ness Cabahug

HEALING OF PARKINSON'S DISEASE THRU KINDNESS

We are glad to announce that through the kindness and generosity of some individuals, we are offering the convention on "HEALING OF PAKINSON'S DISEASE THRU G-MEN (GOD, MEDICINE, EXERCISE AND NUTRITION)" for FREE with a GUARANTEED SEAT and SLOT to a LIMITED NUMBER OF PARTICIPANTS on or before SEPTEMBER 30, 2011.

SCRIPTURES:

"Thus says the Lord: Let not the wise man glory in his kingdom, nor the strong man glory in his strength, nor the rich ma glory in his riches; But rather, let him who glories, glory in this, that in his prudence he knows me, Knows that I, the Lord, bring about KINDNESS, justice and uprightness on the earth; For with such am I pleased, says the Lord.

Jeremiah 9: 22-23

"A slave of the Lord should not quarrel, but should be gentle with everyone, able to teach, tolerant, correcting opponents with KINDNESS. It may be that God will grant them repentance that leads to knowledge of the truth, and that they may return to their senses out of the devil's snare, where they are entrapped by him, for his will."

2 Timothy 2:24-26

"But the Lord's KINDNESS is forever, toward the faithful from age to age. He favors the children's children of those who keep his covenant, who take care to fulfill its precepts."

Psalm 103:17-18

PRAYER:

Dearest God, the Father, thank You, for showing us Your endless kindness through other people's deeds. Thank you, Jesus, God the Son, for giving us the courage to pursue the Lord's plan for our lives. May God, the Holy Spirit, grant us the wisdom and the knowledge so that we will know what to say, when to say and how to say the words so we can bring more people closer to God through our generosity. Mother Mary, thank you for your intercession as we await the healing of our mind, body and soul.

ACTION:

Today, I will extend my own act of kindness to anyone who crosses my path through a winning smile, a sincere praise and a shared blessing.

P.S. Register for FREE on or before September 30, 2011.

P.P.S. Register for a GUARANTEED SEAT and SLOT in the workshop to a LIMITED NUMBER of participants on or before September 30, 2011.

P.P.P.S. Submit REGISTRATION DETAILS (Name, Age, Contact number and E-mail address) on or before September 30, 2011 to avail of FREE REGISTRATION and send via email to drajoy31@yahoo.com / drajoy31@gmail.com

Pinoy PD Thru G-MEN

View another webinar from Ness Cabahug