NCLEX Question 15
The patient asks the nurse to explain the difference between carbidopa-levodopa (Sinemet) and ropinirole (Requip). How will the nurse respond?
"Ropinirole is a dopamine agonist that has fewer adverse effects than carbidopa-levodopa."
A patient with Parkinson's disease who has been positively responding to carbidopa-levodopa (Sinemet) asks the nurse, "Why have I suddenly developed a relapse of my symptoms." Which explanation by the nurse is appropriate?
"This is called the "on-off phenomenon." Your health care provider can change your medication regimen to help manage this effect."
When teaching a patient about carbidopa-levodopa (Sinemet), what information should the nurse include about this medication?
Carbidopa decreases levodopa's conversion in the periphery, increasing the levodopa available to cross the blood-brain barrier.
Which antiparkinson drug causes an increase in the levels of dopaminergic stimulation in the central nervous system (CNS) and therefore allows a decreased dose of other medications?
Selegiline
The nurse is caring for a patient with Parkinson's disease who has been taking entacapone (Comtan) for the past week to treat an on-off phenomenon. The patient expresses concern over brown-orange urine. What information will the nurse provide to the patient?
This is a normal adverse effect of entacapone (Comtan) and is not harmful.
What is the goal of pharmacologic therapy in treating Parkinson's disease?
To balance cholinergic and dopaminergic activity in the brain
A patient with Parkinson's disease discusses with the nurse experiencing insomnia recently. The patient asks the nurse, "Can I take my old prescription of benzodiazepine that is prescribed to treat my insomnia?" What does the nurse know about the use of benzodiazepines in patients taking levodopa (Larodopa)?
Use of benzodiazepines decreases the therapeutic effect of the levodopa and may result in an increase in the symptoms of Parkinson's disease.
A patient who has been taking antiparkinson medications for years begins to have increased symptoms on a constant basis. In documenting these symptoms, what term will the nurse use?
Wearing-off phenomenon
The nurse is providing care for a patient with a diagnosis of Parkinson's disease who has preexisting liver failure. What class of medications, if prescribed, would the nurse question?
Catechol ortho-methyltransferase (COMT) inhibitors
A patient is prescribed selegiline (Eldepryl), an MAO-B inhibitor, as adjunctive therapy in treatment of Parkinson's disease. What potential adverse effects should the nurse include in education for this patient?
Headache, Insomnia, Depression & Blood pressure changes