Pharmacology: Carbidopa-Levodopa and Rivastigmine
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Questions and Answers

Which statement explains the action of carbidopa-levodopa?

Carbidopa prevents levodopa decarboxylation in the periphery, resulting in more levodopa being transported to the brain.

Through which route is carbidopa-levodopa excreted?

Urine

Match the class of drugs used to treat Parkinson's disease with its mechanism of action.

Dopaminergics = Affect dopamine content of the brain Dopamine agonists = Stimulate dopamine receptors of nerve cells in the brain Anticholinergics = Inhibit activity of acetylcholine MAO-B inhibitors = Inhibit activity of monoamine oxidase (MAO)

Which statement correctly explains the action of rivastigmine?

<p>Increases availability of acetylcholine in the neuron receptors</p> Signup and view all the answers

Which route of administration for rivastigmine results in a peak concentration between 8 and 16 hours?

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

Which side effects would the nurse teach Mrs. Hill to expect while taking rivastigmine? (Select all that apply)

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

Which information related to rivastigmine would the nurse provide Mrs. Hill?

<p>&quot;Rise slowly from sitting or lying positions, because orthostatic hypotension can occur.&quot;</p> Signup and view all the answers

Which baseline laboratory tests would be obtained for a female patient who has been prescribed carbidopa-levodopa? (Select all that apply)

<p>Liver function tests (LFTs)</p> Signup and view all the answers

Which adverse effect of carbidopa-levodopa would the nurse teach the patient and family to report to the health care provider?

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

Which instructions would the nurse include in patient teaching for a patient taking extended-release carbidopa-levodopa? (Select all that apply)

<p>&quot;You may continue to have symptoms for several weeks or months.&quot;</p> Signup and view all the answers

Which phrase describes a correct therapeutic goal for treatment of Parkinson's disease?

<p>Improve the patient's ability to carry out activities of daily living</p> Signup and view all the answers

Which statement about carbidopa-levodopa is accurate?

<p>Carbidopa-levodopa should not be stopped abruptly.</p> Signup and view all the answers

Which statement about the mechanism of action of carbidopa is accurate?

<p>Carbidopa has no therapeutic effect on its own.</p> Signup and view all the answers

A nurse administers oral carbidopa-levodopa to a patient who has tremors caused by Parkinson's disease. The nurse would expect to see the medication effect in which time frame?

<p>5 hours</p> Signup and view all the answers

Which statement is accurate about the pharmacodynamics of topical rivastigmine?

<p>Onset of action is 0.5 to 1 hour.</p> Signup and view all the answers

Which description of the therapeutic effect of rivastigmine is accurate?

<p>Improves memory</p> Signup and view all the answers

Rivastigmine must be used with caution in patients with which condition?

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

A nurse is evaluating the effectiveness of a patient's drug regimen for Alzheimer's disease. Which assessment finding by the nurse would indicate that the drug is effective?

<p>Improvement in mental status</p> Signup and view all the answers

A patient has been taking carbidopa-levodopa for many years. During assessment, the nurse finds that the patient presents with hand tremors, drooling, and a mask-like facial expression. Which action would the nurse anticipate incorporating into the plan of care?

<p>Increase in medication dosage</p> Signup and view all the answers

Which foods would the nurse instruct a patient who is taking selegiline to avoid? (Select all that apply)

<p>Red wine</p> Signup and view all the answers

The nurse is providing education to a patient taking carbidopa-levodopa. Which statement by the nurse correctly explains why the patient should take this medication with low-protein foods?

<p>&quot;High-protein foods interfere with transportation of this medication to the central nervous system.&quot;</p> Signup and view all the answers

A patient taking an antihypertensive drug and carbidopa-levodopa tells the nurse that he or she is applying for a job that involves operating heavy machinery. Which information would the nurse share with the patient?

<p>&quot;These medications together may increase your risk for hypotension, so you will need to use caution when operating heavy machinery.&quot;</p> Signup and view all the answers

Study Notes

Carbidopa-Levodopa

  • Carbidopa prevents levodopa decarboxylation in the periphery, enhancing levodopa transport to the brain.
  • Excreted via urine.
  • Prescribed baseline laboratory tests include complete blood count (CBC), liver function tests (LFTs), prolactin level, and pregnancy test.
  • Administered orally, with effects expected within 5 hours.
  • Dosage increase may be required if symptoms like hand tremors and drooling worsen over time.
  • Should not be abruptly discontinued to avoid withdrawal effects.
  • High-protein foods can interfere with medication absorption; low-protein meals are recommended.
  • Side effects include dyskinesia, which should be reported to healthcare providers.
  • Patients may experience discolored urine or dark perspiration.

Rivastigmine

  • Increases availability of acetylcholine at neuron receptors, enhancing cognitive function.
  • Transdermal administration yields peak concentration between 8 and 16 hours.
  • Common side effects include nausea, diarrhea, anorexia, and headache.
  • Important to advise gradual position changes to avoid orthostatic hypotension.
  • Onset of action via transdermal route is 0.5 to 1 hour.
  • Therapeutic effect is aimed at improving memory; effectiveness shown by mental status improvement.
  • Caution required in patients with asthma.

General Treatment Considerations

  • Treatment goals for Parkinson's Disease aim to enhance daily living activities.
  • Patients taking selegiline should avoid tyramine-rich foods such as aged cheeses, red wine, and bananas.
  • Caution is advised when operating heavy machinery due to potential hypotension from combined antihypertensive and Parkinson's medications.

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Description

This quiz focuses on the pharmacological aspects of Carbidopa-Levodopa and Rivastigmine. Test your knowledge on their administration, side effects, mechanisms of action, and patient management considerations. Perfect for students studying pharmacology or healthcare professionals looking to refresh their knowledge.

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