Pathopharmacology III Exam 1 Drugs

Contraindications with apomorphine

Hypersensitivity

Side effects of apomorphine

Angina Dizziness Drowsiness Dyskinesia Ecchymosis Edema Hallucinations Hypotension Inj. site reaction Nausea Orthostatic hypertension Peripheral edema Rhinorrhea Vomiting Yawning

Levodopa/carbidopa side effects

Anorexia N/V Dysphagia Dyskinesia Erythema Fatigue Dizziness Headache Dryness (dry dry dry) Bitter taste Twitching Blurred vision Insomnia Excess dark sweating Urine discoloration

Levodopa/carbidopa education

Do not take if you have glaucoma Take with food to avoid N/V Do not take with MAOIs, can increase depression Low protein diet for better absorption Can increase lab value results

What class is apomorphine?

Dopamine agonist

What class is levodopa/carbidopa?

Dopaminergic

What class is levodopa?

Dopaminergic

Contraindications with levodopa/carbidopa?

Glaucoma Heart disease Kidney disease Hepatic disease Suspicious skin lesions MAOIs Dyskinesia Pulmonary disease

Levodopa/carbidopa mechanism of action

Inhibits dopa decarboxylase, which allows more levodopa to the brain.

Levodopa/carbidopa adverse effects?

Involuntary movements Angioedema Palpitations Orthostatic hypotension Urinary retention Priapism Psychosis Depression/suicidal thoughts Hallucinations Sudden sleep onset Impulse control symptoms LT: Agranulocytosis Hemolytic anemia Leucopenia Thrombocytopenia Heart dysrythmias NMS with abrupt discontinuation

Levodopa side effects

N/V Dyskinesia Orthostatic hypotension Heart dysrythmias Psychosis Cough Chest Pain Infection Pharyngitis

Levodopa contraindications

Narrow angle glaucoma

Mechanism of action for apomorphine

Stimulates DA receptor activation Used for intermittent treatment of off episodes (end of dose weaning off) and unpredictable on/off episodes.

Levodopa education points

Take with food to avoid N/V. Establish medication regimen Do not abruptly stop taking to avoid rebound symptoms of Parkinsons.

Education for apomorphine

Test dose done. During test dose monitor BP closely every 20 minutes for up to one hour. Stand slowly in case of dizziness Monitor for inj. site reaction.

Levodopa mechanism of action

The enzyme dopa decarboxylase converts levodopa to DA in the brain, but is also found in the body. 99% is converted in the body, while only 1% is converted in the brain, which doesn't make this medication super effective.