Pharm Exam 1: Carbidopa-Levodopa

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Questions and Answers

What is the pharmacologic classification for Carbidopa-Levodopa?

Dopamine Agonist

What is indicated for the use of Carbidopa-Levodopa?

Parkinson's Disease

What are the therapeutic goals/actions for Carbidopa-Levodopa? (Select all that apply)

  • Inhibition of dopamine breakdown (correct)
  • Higher levels of dopamine
  • Relief of tremor and rigidity (correct)
  • Decrease heart rate

What is converted into dopamine?

<p>Levodopa</p> Signup and view all the answers

What is an inhibitor that prevents the breakdown of dopamine?

<p>Carbidopa</p> Signup and view all the answers

Carbidopa crosses the blood-brain barrier (BBB).

<p>False (B)</p> Signup and view all the answers

Which conditions are contraindicated for Carbidopa-Levodopa? (Select all that apply)

<p>Melanoma (A), Glaucoma (C)</p> Signup and view all the answers

What are some adverse effects of Carbidopa-Levodopa? (Select all that apply)

<p>Darkens sweat and urine (C), Nausea (D)</p> Signup and view all the answers

Which medications interact with Carbidopa-Levodopa? (Select all that apply)

<p>Benzodiazepines (B), Antipsychotics (C), Non-Selective MAOIs (D)</p> Signup and view all the answers

What does the 'wearing off' effect refer to?

<p>'Wearing off' refers to diminished effectiveness after 5-10 years of use.</p> Signup and view all the answers

What are some patient education points regarding Carbidopa-Levodopa?

<p>High protein diet impairs levodopa's function, Vitamin B6 can interfere, and monitor for wearing off effect.</p> Signup and view all the answers

What are the desired outcomes for patients taking Carbidopa-Levodopa?

<p>Resolutions of PD signs/symptoms.</p> Signup and view all the answers

Flashcards

Carbidopa-Levodopa Class

A medication classified as a dopamine agonist.

Carbidopa-Levodopa Use

Primarily used to alleviate symptoms of Parkinson's Disease.

Carbidopa-Levodopa Action

Levodopa converts to dopamine in the brain, while carbidopa prevents dopamine breakdown.

Levodopa vs. Carbidopa Function

Levodopa gets converted into dopamine, and carbidopa stops its breakdown.

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Carbidopa-Levodopa Barriers

Carbidopa doesn't cross into the brain, but both drugs can enter breast milk.

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Carbidopa-Levodopa Warnings

Contraindicated in glaucoma, caution advised with melanoma.

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Carbidopa-Levodopa Side Effects

Can cause dyskinesia, nausea, and may increase melanoma risk.

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Carbidopa-Levodopa Interactions

Non-selective MAOIs, benzodiazepines, antipsychotics, and vitamin B6.

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Carbidopa-Levodopa Diet

High protein diets and vitamin B6 may reduce drug effectiveness.

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"Wearing Off" Phenomenon

Medication effectiveness decreases over time.

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Melanoma Monitoring

Instruct patients to monitor for new or changing skin lesions (melanoma).

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Therapeutic Timeline

Effects take 2-3 weeks, full effect up to 6 months to manifest fully.

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Study Notes

Pharmacologic Classification

  • Carbidopa-Levodopa is classified as a dopamine agonist.

Indications

  • Primarily indicated for the treatment of Parkinson's Disease.

Therapeutic Goals and Actions

  • Aims to provide relief from tremors and rigidity in patients with Parkinson's Disease.
  • Levodopa is converted into dopamine in the brain to enhance motor function.
  • Carbidopa inhibits the enzyme that breaks down dopamine, increasing its availability in the brain.

Key Components

  • Levodopa is the substance that gets converted into dopamine.
  • Carbidopa prevents the breakdown of dopamine, enhancing the effectiveness of Levodopa.

Pharmacokinetics

  • Carbidopa does not cross the blood-brain barrier but can cross the placenta.
  • Both Carbidopa and Levodopa are excreted in breast milk.

Contraindications

  • Not recommended for patients with glaucoma.
  • Caution advised for individuals with melanoma.

Adverse Effects

  • Potential side effects include dyskinesia, nausea, and vomiting.
  • Can lead to melanoma, darkened sweat and urine, cardiac dysrhythmias, hypotension, and muscle cramps.

Drug Interactions

  • Non-selective MAOIs can interact negatively with Carbidopa-Levodopa.
  • Interactions with benzodiazepines, antipsychotics, and vitamin B6 (Pyridoxine) can occur.
  • Dietary protein may impair the effectiveness of Levodopa.
  • Anticholinergics may work in conjunction with cholinergic medications.

Nurse Safety Considerations

  • "Wearing off" phenomenon may occur, where the medication loses effectiveness over time (5-10 years).
  • "Wearing on/off" phenomenon affects some patients, fluctuating between symptom control and lack of control.

Patient Education

  • Advise against a high-protein diet, which can impair Levodopa absorption.
  • Monitor for indications of melanoma risk.
  • Educate patients that vitamin B6 can interfere with Levodopa's effectiveness.
  • Discuss the "wearing off" effect and its potential impact on treatment.

Outcomes

  • Expected to see resolutions of Parkinson's Disease signs and symptoms.
  • Therapeutic effects can take anywhere from 2-3 weeks to 6 months to manifest fully.

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