Pharm Ch. 15 Antiparkinson Drugs

A patient receives a diagnosis of Parkinson's disease. Which intervention does the nurse implement first?

Explaining diseases characteristics

The nurse is caring for a patient who has a 10-year history of Parkinson's disease. Which assessments are appropriate for the nurse to make before referral for therapy? Select all that apply.

Gait Speech Balance

A patient with Parkinson's disease needs an anticholinergic agent to help relieve dyskinesia. Which assessments would the nurse make before administering the medication? Select all that apply.

Genitourinary Cerebrovascular Gastrointestinal

Which statement describes the difference between carbidopa-levodopa and ropinirole?

Ropinirole is a dopamine agonist that has fewer side effects than carbidopa-levodopa.

Which antiparkinson drug causes an increase in the levels of dopaminergic stimulation in the central nervous system and therefore allows a decreased dose of other medications?

Selegiline

Which drug is used as an adjunct therapy with carbidopa-levodopa to treat Parkinson's disease?

Selegiline

During the follow-up visit, the nurse finds that a patient with Parkinson's disease is having an on-off phenomenon caused by levodopa. Which findings caused the nurse to reach this conclusion?

Uncontrollable voluntary movements

Which findings will the nurse anticipate while assessing a patient with Parkinson's disease? Select all that apply.

Weakness Muscle rigidity Resting tremor.

A patient who has been taking antiparkinson medications for years begins to have increased symptoms on a constant basis. In documenting these symptoms, which term will the nurse use?

Wearing-off phenomenon

Which potential side effects should be included in the teaching plan for a patient prescribed selegiline? Select all that apply.

Headache Insomnia Depression Blood pressure changes

A patient is experiencing constant impairment of voluntary actions after taking levodopa. What is the nurse's priority action?

Instruct the patient to stay in bed

Which enzyme is inhibited by the antiparkinson drug selegiline?

Monoamine oxidase

Which point is important for the nurse to include in the teaching plan for a patient with Parkinson's disease who has been prescribed amantadine?

"Change positions slowly."

A patient is receiving benztropine. Which is an essential point for the nurse to teach the patient about therapy?

"Avoid exercise during hot weather."

Which instruction does the nurse provide to a patient who is taking a catechol ortho-methyltransferase (COMT) inhibitor?

"Avoid taking the medicine on an empty stomach."

Which antiparkinson drug is useful in the treatment of prolactin-secreting tumors?

Bromocriptine

Which antiparkinson medication is a levodopa enhancer?

Carbidopa

Which is the main anatomic area of the brain that is affected in a patient with Parkinson's disease?

Substantia nigra

The nurse is caring for a patient who has Parkinson's disease and has been prescribed selegiline. Which dietary restriction would the nurse include in the patient's discharge teaching plan?

"Do not eat yogurt and cheese while on this medication."

The nurse is teaching the patient's caregiver about the administration of entacapone. Which statement made by the caregiver indicates the need for additional education?

"I will administer the drug when the patient has an empty stomach."

The health care provider has prescribed an indirect-acting dopamine receptor agonist and a dopamine replacement drug to a patient with Parkinson's disease. Which advice would the nurse give to the patient to increase the effectiveness of the treatment?

"Perform regular physical activity."

Which statement made by a patient indicates an understanding of the treatment of Parkinson's disease?

"The medications will slow down the progression of my symptoms."

A patient with Parkinson's disease who has been responding well to drug treatment with levodopa suddenly develops a relapse of the symptoms. Which explanation by the nurse is appropriate?

"This is called the 'wearing-off' phenomenon. Your health care provider can change your medication regimen slightly to help diminish this effect."

Which point will be included in the teaching plan for a patient receiving entacapone?

"Your urine may change to a brown-orange color."

A patient who is taking a high dose of selegiline should avoid consuming which food?

Aged cheese

Which antiparkinson medication is also an antiviral drug used to treat the influenza virus?

Amantadine

Which drug indicated for Parkinson's disease acts by releasing dopamine and blocking the reuptake of dopamine into nerve fibers?

Amantadine

Which condition is a contraindication for administration of carbidopa-levodopa?

Angle-closure glaucoma

The nurse notes that a patient taking ropinirole for Parkinson's disease has been prescribed ciprofloxacin for a urinary tract infection. Which action would the nurse take?

Assess the patient for toxicity and notify the health care provider.

Which teaching point is essential for a patient with Parkinson's disease who is prescribed benztropine?

Avoid alcohol while taking the medication.

A patient with Parkinson's disease takes carbidopa-levodopa but experiences disabling tremors. Which adjunct medications can be administered for alleviation of the patient's tremors? Select all that apply.

Benztropine Trihexyphenidyl

Which teaching point will the nurse include about carbidopa-levodopa?

Carbidopa decreases levodopa's conversion in the periphery, increasing the levodopa available to cross the blood-brain barrier.

Which complication may be increased because of the combined use of catechol ortho-methyltransferase (COMT) inhibitors and monoamine oxidase inhibitors (MAOIs)?

Cardiovascular risk

Which class of drugs is administered to treat on-off phenomenon in a patient with Parkinson's disease?

Catechol ortho-methyltransferase

Which class of drugs is administered to treat on-off phenomenon in a patient with Parkinson's disease?

Catechol-ortho-methyltransferase

Which part of the brain regulates muscle coordination?

Cerebellum

The nurse is caring for a patient who has been prescribed entacapone to reduce the on-off effects of carbidopa-levodopa. Which action will the nurse take to assess for any adverse effects in the patient? Select all that apply.

Check the patient's urinalysis reports. Observe for any abnormal movements. Assess the patient for vomiting and diarrhea.

What will the nurse do to assess a patient for adverse effects due to a combination therapy of entacapone and selegiline? Select all that apply.

Check the patient's urine reports. Record the patient's blood pressure. Frequently assess the patient's pulse rate.

Which outcome in a patient started on carbidopa-levodopa indicates a therapeutic effect of the medication?

Decreased tremors

Benzodiazepines cause which drug interaction if taken during levodopa therapy?

Decreases the therapeutic effect of the levodopa and may result in an increase in the symptoms of Parkinson's disease

Which medication is contraindicated for a patient receiving selegiline for Parkinson's disease?

Dextromethorphan

Which intervention is safest for a patient who gains 8 kg in a week while taking pramipexole?

Discontinue pramipexole

Which inhibitory neurotransmitter is involved in Parkinson's disease?

Dopamine

Which substance, if out of balance with acetylcholine, leads to Parkinson's disease?

Dopamine

Which possible adverse effects are associated with the use of dopamine replacement drugs? Select all that apply.

Dyskinesia Palpitations Urinary retention

The health care provider has prescribed selegiline to a patient with Parkinson's disease. While doing a medication review, the nurse finds the patient has been receiving entacapone. Which is the nurse's best action?

Hold the selegiline and notify the health care provider.

The nurse advises a patient taking a nonselective monoamine oxidase inhibitor (MAOI) not to drink red wine and beer in order to avoid which adverse outcome?

Hypertensive crisis

Monoamine oxidase inhibitors (MAOIs) are prescribed along with carbidopa-levodopa for which reason?

Increases the efficacy of carbidopa-levodopa

Which assessment is appropriate for a patient who has recently been diagnosed with Parkinson's disease and was prescribed tolcapone?

Liver function

The nurse observes that despite taking amantadine for a year, a patient with Parkinson's disease has muscle stiffness and slowed movements. Which drug may help this patient?

Pramipexole

The nurse observes that a patient has severe dyskinesia and tremors in the fingers. The patient reports uneven leg movements at night that disturb sleep. Which combination therapy does the nurse expect the health care provider to prescribe?

Ropinirole and carbidopa-levodopa

Which mechanism of action explains why levodopa is the mainstay of treatment for patients with Parkinson's disease?

Provides a dopamine precursor

Which description of carbidopa-levodopa explains why it is the drug of choice for the treatment of Parkinson's disease in older adult patients?

Relatively safe drug

Which teaching point would be included in the teaching plan about entacapone? Select all that apply.

This medication may darken your urine, but it is a harmless side effect. Report any back pain or jaundice because this may indicate liver dysfunction. This medication should be taken with meals to decrease gastrointestinal (GI) upset.

Which drug is contraindicated in the patient with liver failure who needs an antiparkinson drug?

Tolcapone

Which are common symptoms of Parkinson's disease? Select all that apply.

Tremor Rigidity Postural instability