Podcast
Questions and Answers
Which medication will most directly affect catecholamine-O-methyl transferase (COMT) function for a client with Parkinson's disease?
Which medication will most directly affect catecholamine-O-methyl transferase (COMT) function for a client with Parkinson's disease?
- Entacapone (correct)
- Levodopa
- Carbidopa
- Rasagiline
What should the nurse caution a client taking levodopa to avoid?
What should the nurse caution a client taking levodopa to avoid?
Vitamin B6
What should the nurse do for a patient who has developed gastrointestinal disturbances after taking carbidopa/levodopa?
What should the nurse do for a patient who has developed gastrointestinal disturbances after taking carbidopa/levodopa?
Administer the next drug dose with meals.
What adverse effect should be closely monitored in a client taking carbidopa-levodopa for Parkinson's disease?
What adverse effect should be closely monitored in a client taking carbidopa-levodopa for Parkinson's disease?
By which route would the nurse expect to administer trihexyphenidyl?
By which route would the nurse expect to administer trihexyphenidyl?
What is a priority action for a client receiving apomorphine?
What is a priority action for a client receiving apomorphine?
What is considered a peripheral anticholinergic effect of anticholinergic drug therapy?
What is considered a peripheral anticholinergic effect of anticholinergic drug therapy?
For which client should the nurse refer to the provider for possible use of adjunctive agents?
For which client should the nurse refer to the provider for possible use of adjunctive agents?
What drug should a client whose Parkinson's disease is being treated with tolcapone concurrently take?
What drug should a client whose Parkinson's disease is being treated with tolcapone concurrently take?
Which medication acts only on the muscle despite most muscle relaxants being CNS depressants?
Which medication acts only on the muscle despite most muscle relaxants being CNS depressants?
What teaching point should the nurse provide for a woman starting Dantrolene for multiple sclerosis?
What teaching point should the nurse provide for a woman starting Dantrolene for multiple sclerosis?
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Study Notes
Parkinson's Disease Medications
- Entacapone affects catecholamine-O-methyl transferase (COMT) function, enhancing the effectiveness of dopaminergic treatments.
- Levodopa should be taken without Vitamin B6, as it decreases its effectiveness; St. John's wort interacts with rasagiline but not levodopa.
- Carbidopa/levodopa can cause gastrointestinal disturbances; administering with meals helps alleviate this side effect.
- Adverse effects of carbidopa-levodopa that need monitoring include involuntary movements.
Administration and Monitoring
- Trihexyphenidyl is administered orally as an adjunctive treatment for Parkinson's disease.
- Apomorphine requires vigilant cardiac status monitoring due to risks of hypotension and prolonged QT interval; administered via subcutaneous injection.
- Peripheral anticholinergic effects of anticholinergic therapy include blurred vision, while central effects can lead to cognitive disturbances like delirium.
Treatment Adjustments
- Clients on carbidopa-levodopa experiencing diminished therapeutic effects after three years may benefit from adjunctive agents.
- Tolcapone should be taken with levodopa/carbidopa for effective treatment; other drugs like ipratropium, atropine, and benztropine are not indicated.
Muscle Relaxants
- Dantrolene is unique among muscle relaxants as it acts directly on skeletal muscle, inhibiting calcium release and thereby decreasing contraction strength.
- Patients prescribed Dantrolene for muscle spasticity should be warned it may exacerbate muscle weakness while alleviating spasticity.
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