Carbidopa/levodopa

A patient is receiving carbidopa-levodopa for parkinsonism. What should the nurse know about this drug? a. Carbidopa-levodopa may lead to hypertension. b. Carbidopa-levodopa may lead to excessive salivation. c. Dopaminergic and anticholinergic therapy may lead to drowsiness and sedation. d. Dopaminergics and anticholinergics are contraindicated in patients with glaucoma.

d. Dopaminergics and anticholinergics are contraindicated in patients with glaucoma.

Carbidopa-levodopa (Sinemet) is prescribed for a client with Parkinson's disease, and the nurse monitors the client for adverse reactions to the medication. Which of the following indicates that the client is experiencing an adverse reaction? 1. Pruritus 2. Tachycardia 3. Hypertension 4. Impaired voluntary movements

4. Impaired voluntary movements Rationale:Dyskinesia and impaired voluntary movement may occur with high levodopa dosages. Nausea, anorexia, dizziness, orthostatic hypotension, bradycardia, and akinesia (the temporary muscle weakness that lasts 1 minute to 1 hour, also known as the "on-off phenomenon") are frequent side effects of the medication

When teaching a patient about carbidopa-levodopa (Sinemet), the nurse responds based on knowledge that A) carbidopa decreases levodopa's conversion in the periphery, increasing the levodopa available to cross the blood-brain barrier. B) carbidopa increases levodopa's conversion in the periphery, enhancing the amount of dopamine available to the brain. C) giving both drugs together minimizes side effects. D) carbidopa crosses the blood-brain barrier to increase the metabolism of levodopa to dopamine in the brain

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

The patient asks the nurse to explain the difference between carbidopa-levodopa (Sinemet) and ropinirole (Requip). The nurse's response is based on knowledge that A) ropinirole is a dopamine agonist that has fewer side effects than carbidopa-levodopa. B) carbidopa-levodopa is less effective than ropinirole in treating the symptoms of Parkinson's disease. C) both drugs have the same pharmacodynamic and side effect profiles. D) carbidopa-levodopa acts as a dopamine agonist, whereas ropinirole directly replaces dopamine.

A) ropinirole is a dopamine agonist that has fewer side effects than carbidopa-levodopa.

Which side effect/adverse effect of carbidopa/levodopa does the nurse realize is most important to monitor? A. Agranulocytosis B.Dysphagia C. Increased Libido D. Urinary Retention

A. Agranulocytosis Rationale: It is most important for the nurse to monitor the client taking carbidopa/ levodopa for agranulocytosis (decreased white blood cells), which is life-threatening. Dysphagia, increased libido, and urinary retention are not life threatening.

Which comment to the nurse indicates more teaching is needed for a client taking carbidopa/levodopa?

Answer: "I know I need to take this drug once a day." Rationale: A statement from the client such as "I know I need to take this drug once a day" indicates that more teaching is needed because carbidopa/levodopa has a short half-life and must be taken 3 or 4 times per day. The other answers are true.

The patient with Parkinson's disease who has been positively responding to carbidopa-levodopa (Sinemet) suddenly develops a relapse of symptoms. Which explanation by the nurse is appropriate? A) "You have obviously developed resistance to your current medication and will have to be switched to another drug." B) "This is an atypical response. Unfortunately, there are no other options of drug therapy to give you." C) "This is called the 'on-off phenomenon.' Your health care provider can change your medication regimen slightly to help diminish this effect." D) "You just need to keep taking your medication and these effects will go away."

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

Dietary instructions for a PT taking Levodopa/Carbidopa A. Eat large amounts of protein-rich foods B. May take the medication with whole-grain cereal C. Consider eating a banana D. May take the med crushed in grapefruit juice

D. May take the med crushed in grapefruit juice. You can take this drug with ANY type of juice

Which is a nursing intervention for a patient taking carbidopa-levodopa for parkinsonism? a. Encourage the patient to adhere to a high-protein diet. b. Inform the patient that perspiration may be dark and stain clothing. c. Advise the patient that glucose levels should be checked with urine testing. d. Warn the patient that it may take 4 to 5 days before symptoms are controlled.

b. Inform the patient that perspiration may be dark and stain clothing.