Antiparkinson Drugs

Question 1

Carbidopa-Levodopa

Chemical Classification

Answer 1

Catecholamine

Question 2

Carbidopa-Levodopa

Mechanism of Action

Answer 2

Decarboxylation of levodopa in periphery is inhibited by carbidopa; more levodopa is made available for transport to the brain and for conversion to dopamine in the brain

Question 3

Carbidopa-Levodopa

Uses

Answer 3

Parkinson’s disease, parkinsonism resulting from carbon monoxide, chronic manganese intoxication, cerebral arteriosclerosis

Question 4

Carbidopa-Levodopa

Contraindications

Answer 4

Hypersensitivity, malignant melanoma, history of malignant melanoma or undiagnosed skin lesions resembling melanoma

Question 5

Carbidopa-Levodopa

Side Effects

Answer 5

CNS: Involuntary Choreiform Movements, Hand Tremors, Fatigue, Headache, Anxiety, Twitching, Numbness, Weakness, Confusion, Agitation, Insomnia, Nightmares, psychosis, hallucination, hypomania, severe depression, dizziness, impulsive behaviors, NEUROLEPTIC MALIGNANT SYNDROME
CV: Orthostatic Hypotension, tachycardia, hypertension, palpitation
EENT: blurred vision, diplopia, dilated pupils
GI: Nausea, Vomiting, Anorexia, Abdominal Distress, Dry Mouth, Flatulence, Dysphagia, bitter taste, diarrhea, constipation
HEMA: HEMOLYTIC ANEMIA, LEUKOPENIA, AGRANULOCYTOSIS
INTEG: rash, sweating, alopecia
MISC: urinary retention, incontinence, weight change, dark urine

Question 6

Carbidopa-Levodopa

Nursing Considerations

Answer 6

ASSESS:

• PARKINSON’S SYMPTOMS: tremors, pill rolling, drooling, akinesia, rigidity, shuffling gait before, during treatment, BP, respiration; orthostatic BP
• Mental Status: affect, mood, behavioral changes, depression, complete suicide assessment
• Toxicity: muscle twitching, blepharospasm
• Renal, hepatic, hematopoietic tests; also for diabetes, acromegaly if on long-term therapy

Question 7

Ropinirole (Requip)

Functional Classification

Answer 7

Antiparkinson agent

Question 8

Ropinirole (Requip)

Chemical Classification

Answer 8

DOPamine-receptor agonist, nonergot

Question 9

Ropinirole (Requip)

Mechanism of Action

Answer 9

Selective agonist for D2 receptors (presynaptic/postsynaptic sites); binding at D3 receptor contributes to antiparkinson effects

Question 10

Ropinirole (Requip)

Uses

Answer 10

Parkinson’s disease, restless leg syndrome (RLS)

Question 11

Ropinirole (Requip)

Contraindications

Answer 11

Hypersensitivity

Question 12

Ropinirole (Requip)

Side Effects

Answer 12

CNS: Agitation, Insomnia, psychosis, hallucination, dystonia, depression, dizziness, somnolence, SLEEP ATTACKS, impulse control disorders
CV: Orthostatic Hypotension, tachycardia, hypo/hypertension, syncope, palpitations
EENT: blurred vision
GI: Nausea, Vomiting, Anorexia, Dry Mouth, constipation, dyspepsia, flatulence
GU: impotence, urinary frequency
HEMA: HEMOLYTIC ANEMIA, LEUKOPENIA, AGRANULOCYTOSIS
INTEG: rash, sweating
RESP: pharyngitis, rhinitis, sinusitis, bronchitis, dyspnea

Question 13

Ropinirole (Requip)

Nursing Considerations

Answer 13

ASSESS:

• PARKINSONISM: akinesia, tremors, staggering gait, muscle rigidity, drooling
• BP, respirations during initial treatment; hypo/hypertension should be reported
• SLEEP ATTACKS: drowsiness, falling asleep without warning even during hazardous activities
• Mental status: affect, mood, behavioral changes, depression; complete suicide assessment; worsening of symptoms in restless leg syndrome

PERFORM/PROVIDE:
-Testing for diabetes mellitus, acromegaly if patient receiving long-term therapy

Question 14

Carbidopa-Levodopa

Functional Classification

Answer 14

Antiparkinson agent