The Importance of Medication Reconciliation in a Patient with Parkinson's Disease.

In this case, a 67-year-old male experienced a progression of his Parkinson's disease symptoms following an inpatient hospitalization for pneumonia. He presents to the neurology clinic for follow-up, where the neurology ambulatory care pharmacist was consulted to assist with his case. The pharmacist identified a medication reconciliation discrepancy that resulted in an unintentional change in the dosing frequency of his carbidopa/levodopa. This, combined with the initiation of metoclopramide, a dopamine-receptor antagonist, led to a worsening of his Parkinson's symptoms. His carbidopa/levodopa dose was titrated back to the previous regimen, metoclopramide was discontinued, and his symptoms significantly improved. This case highlights the importance of best practices in medication reconciliation for patients with Parkinson's disease, the impact of drug-disease interactions, and emphasizes the critical role of ambulatory care pharmacists in geriatric patient care.