Pharmacist's role in a Parkinson's disease and movement disorders clinic.

Purpose: The expanding role of a clinical pharmacist at a Veterans Affairs (VA) out-patient clinic for patients with Parkinson's disease (PD) and movement disorders is described.

Summary: San Francisco VA Medical Center added a clinical pharmacist to the multi-disciplinary team serving patients at an outpatient clinic operated by its Parkinson's Disease Research, Education and Clinical Center (PADRECC). During the first six months after joining the clinic team, the pharmacist met with 131 patients and made a total of 69 drug therapy recommendations that were implemented by neurologists, clinical nurse specialists, and other PADRECC providers.

Sildenafil for pulmonary hypertension.

Objective: To evaluate the efficacy of sildenafil for treatment of pulmonary hypertension.

Data Sources: Literature retrieval was accessed through MEDLINE (1977-March 2005), Cochrane Library, and International Pharmaceutical Abstracts (1977-March 2005) using the terms sildenafil and pulmonary hypertension. In addition, reference citations from publications identified were reviewed.

Role of pentoxifylline and vitamin E in attenuation of radiation-induced fibrosis.

Objective: To evaluate the use of pentoxifylline and vitamin E as monotherapy and in combination for the treatment of radiation-induced fibrosis (RIF).

Data Sources: Literature retrieval was performed through MEDLINE (1966-March 2004) using the terms vitamin E, alpha-tocopherol, pentoxifylline, radiation-induced fibrosis, and radiation injury.

Data Synthesis: Few treatments exist for managing RIF of soft tissues.

Thalidomide-induced sinus bradycardia.

Objective: To report a case of thalidomide-induced sinus bradycardia in an elderly man.

Case Summary: A 72-year-old white man, with transfusion-dependent refractory anemia with ringed sideroblasts and hypertension treated with atenolol, was started on thalidomide 100 mg at bedtime. During the dose titration period (maximum dose 400 mg/d), his heart rate decreased from a baseline of 63 beats/min to as low as 44 beats/min with positive electrocardiogram findings of sinus bradycardia.