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Slide Presentation from the AHRQ 2007 Annual Conference

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The Prescribing Cascade (continued)

Text Description is below the image.

Flowchart showing "The Prescribing Cascade"

Metoclopramide leads to Extrapyramidal Effects, which leads to the prescription of Levodapa Rx

Notes:

Let me give you some specific examples. The first study involves the drug metoclopramide. Since metoclopramide first became available as a gastric motility agent, there have been numerous reports in the literature of unwanted extrapyramidal side effects including drug-induced parkinsonian symptoms. Idiopathic Parkinson's Disease is certainly seen with greater frequency in older patients. However, it would be very problematic if drug-induced parkinsonian symptoms were misinterpreted as Parkinson's Disease. Levodopa therapy is relatively specific to the treatment of idiopathic Parkinson's Disease. So, in this study we employed levodopa therapy as a proxy for the occurrence of this event.


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