April 2023: practical updates on Parkinson's, HIV, Raynaud's and eye antibiotics

April 2023 on DoctorAlexa brought four focused posts that matter to patients and clinicians. Each piece looks at a drug from a real-world angle — how it changes daily life, where the evidence stands, and what to watch for. If you want short, useful summaries you can act on or discuss with your doctor, you’re in the right place.

The first post covered trihexyphenidyl and occupational therapy for Parkinson’s. Trihexyphenidyl is an anticholinergic that can reduce tremor and muscle stiffness, which sometimes makes daily tasks easier. Occupational therapists can pair medication adjustments with task-focused strategies — for example, adaptive utensils or energy-saving routines — to boost independence. Side effects like dry mouth, confusion, and blurred vision show up more in older adults, so dose carefully and check cognitive status regularly.

Another April post looked at the future of efavirenz‑emtricitabine‑tenofovir (EET) in HIV care. EET has a long track record for viral suppression, but newer regimens are improving tolerability and resistance profiles. Expect ongoing research to refine dosing, reduce side effects, and expand access in lower-resource settings. For patients, the takeaways are simple: stick with your regimen, report neuropsychiatric symptoms early with efavirenz, and ask about newer alternatives if side effects interfere with daily life.

Baclofen cropped up as a possible option for Raynaud’s phenomenon. It’s primarily a muscle relaxant, and some small studies or case reports suggest it might ease spasms that trigger color changes and pain. Evidence is limited, so baclofen is still an experimental or secondary option rather than a standard treatment. Watch for sedation, dizziness, and withdrawal symptoms if stopping suddenly; discuss tapering plans with your clinician.

The last April post explored besifloxacin and the ophthalmic microbiome. Besifloxacin is a topical fluoroquinolone used for bacterial eye infections; it can clear pathogens quickly, but antibiotics also alter the normal eye flora. Overuse raises the risk of resistance and may shift microbial balance, so reserve topical antibiotics for confirmed or strongly suspected bacterial infections and follow prescribed durations. If infections recur, culture and sensitivity testing can guide smarter choices.

Key takeaways from these posts

Think about function, not just symptoms: trihexyphenidyl works best when combined with occupational strategies that target real tasks.

For HIV, efficacy remains crucial, but tolerability and access are shaping the next steps for EET and its competitors.

Baclofen for Raynaud’s is intriguing but early — use only under supervision and monitor side effects closely.

With besifloxacin, short targeted courses and stewardship reduce resistance and protect the eye’s normal microbiome.

Practical tips for patients and clinicians

If you have Parkinson’s and medication helps your tremor, ask your occupational therapist about specific tools and routines to build on that drug benefit. If you’re on efavirenz‑based HIV therapy and feel mood changes or sleep problems, tell your provider — alternatives exist. For Raynaud’s, try first-line lifestyle steps (warmth, quitting smoking) and reserve baclofen discussions for refractory cases. For eye infections, get a clear diagnosis, avoid self-prescribing drops, and request cultures when infections repeat.

Want details from each April post? Read the full articles for references, patient scenarios, and links to studies that informed these notes. Use these summaries as starting points for a focused conversation with your healthcare team.