Medications

Question 1

Levodopa

Answer 1

Mechanism of Action: Converts dopamine in the brain

Therapeutic Uses: Relieves the motor symptoms of PD

Adverse Effects: Dizziness, Loss of appetite, Trouble sleeping, unusual dreams, Headache

“On-Off” Phenomenon:
> Switch between mobility and immobility
> Occurs as an end-of-dose or “wearing off” that worsens motor function
> Alteration between period improved mobility are “on” periods when responding to medication
> Impaired motor function is when response to med is poor or the “off” response

Question 2

Levodopa/Carbidopa

Answer 2

Mechanism of Action: Converts to dopamine in the brain. Addition of carbidopa prevents the levodopa from being broken down before it reaches the brain

Therapeutic Uses: Relieves motor symptoms of PD

Adverse Effects:
(1) Involuntary movements
(1) Head bobbing
(2) Grimacing
(3) Ballismus (twisting, jerking, shaking)
(2) Visual hallucinations
(3) Paranoid ideation
(4) Vivid dreams and nightmares
(5) Psychosis

Important Nursing Implications
(1) Food delays absorption
(2) High protein foods reduce therapeutic effects
(Advise patients to spread protein consumption evenly throughout day)

Question 3

Nifedipine

Answer 3

Mechanism of Action:

Therapeutic Effect:

Adverse Effects:

Question 4

Alteplase (Activase)

Answer 4

Mechanism of Action:

Therapeutic Effect:

Adverse Effects:
(1) Cerebral Hemorrhage
(2) Arrhythmias
(3) Cholesterol Embolization
(4) Venous Thrombosis
(5) GI bleeding
(6) GU bleeding
(7) Spontaneous bleeding

Question 5

Mannitol

Answer 5

Mechanism of Action:

Therapeutic Effect:

Adverse Effect: