Chapter 15: Antiparkinson Drugs Flashcards
Carbidopa-levodopa (Sinemet) is prescribed for a patient with Parkinson’s disease. The nurse informs the patient that which common adverse effects can occur with this medication?
Heart palpitations, hypotension, urinary retention
Dyskinesia and Depression are also common side effects.
When a patient is taking an anticholinergic such as benztropine (Cogentin) as part of the treatment for Parkinson’s disease, the nurse should include which information in the teaching plan?
Use artificial saliva, sugarless gum, or hard candy to counteract dry mouth
Dry mouth can be managed with artificial saliva through drops or gum, frequent mouth care, forced fluids, and sucking on sugar-free hard candy
Anticholonergic drugs are known to cause dry mouth. This effect is reduced by keeping something in the mouth to induce saliva production. Therefore, the nurse should advise the patien to chew sugar-free gum, suck on hard candy, or use artificial saliva drops and perform frequent oral care.
A patient has been given a prescription for levodopa-carbidopa (Sinemet) for her newly diagnosed Parkinson’s disease. She asks the nurse, “Why are there two drugs in this pill?” The nurse’s best response reflects which fact?
Carbidopa prevents the breakdown of levodopa in the periphery
When given in combination with levodopa, carbidopa inhibits the breakdown of levodopa in the periphery and thus allows smaller doses of levodopa to be used. Lesser amounts of levodopa result in fewer unwanted adverse effects. Levodopa, not carbidopa, is the biologic precursor of dopamine and can penetrate into the CNS.
When treating patients with medications for Parkinson’s disease, the nurse knows that the wearing-off phenomenon occurs for which reason?
The medications begin to lose effectiveness against Parkinson’s disease
The wearing-off phenomenon occurs when antiparkinson medications begin to lose their effectiveness, despite maximal dosing, as the disease progresses
A patient has been treated with antiparkinson medications for 3 months. What therapeutic responses should the nurse look for when assessing this patient?
Improved ability to perform activities of daily living
Therapeutic responses to antiparkinson agents include an improved sense of well-being, improved mental status, increased appetite, increased ability to perform activities of daily living and to concentrate and think clearly, and less intense parkinsonian manifestations
A patient taking entacapone (Comtan) for the first time calls the clinic to report a dark discoloration of his urine. After listening to the patient, the nurse realizes that what is happening in this situation?
This is a harmless effect of the drug.
COMT inhibitors, including entacapone, may darken a patient’s urine and sweat.
A patient has a new order for a catechol ortho-methyltransferase (COMT) inhibitor as part of treatment for Parkinson’s disease. The nurse recognizes that which of these is an advantage of this drug class?
It is associated with fewer wearing-off effects
COMT inhibitors are associated with fewer wearing-off effects and have prolonged therapeutic benefits. They have a quicker onset, and they prolong the duration of action of levodopa.
