Multidisciplinary approaches to managing PD

Question 1

Who is involved in the MDT in a parkinson’s patient?

Answer 1

• GP
• Social worker
• PD nurse specialist
• Physiotherapists
• Occupational therapists
• Speech & language therapists (improves swallowing, communication & salivating)
• Nutritionist (it is thought that protein can affect the absorption of levodopa; discuss a diet in which most of the protein is eaten in the final meal of the day for pD pts who experience motor fluctuations with levodopa; take vit D supplement as it’s thought to delay onset of cognitive impairment & depression)
• Psychiatrist/counsellor
• Family/friend
• Patient

Question 2

What is the Alexander technique?

Answer 2

• A skill for self-development teaching you to change long-standing habits that cause unnecessary tension in everything you do
• Whatever your age or ability, the Technique can help boost your performance in any activity and relieve the pain and stress caused by postural habits, like slouching or rounded shoulders.
• Working with your teacher, you will learn to recognize your usual reactions to the stresses of life. You will find out how you have been contributing to your problems, how to prevent them and regain control

Question 3

How does protein affect absorption of Levodopa

Answer 3

• High protein diet can lead to less effective L-DOPA response
• Protein thought to compete with L-DOPA for absorption
• L-DOPA (sinemet) is a protein building block so it competes for absorption with other proteins

Question 4

What is entacapone used for

Answer 4

• COMT inhibitor
• Tries to extend the half-life of L-DOPA in the blood in order to reduce motor fluctuations and ‘off’ periods with their PD