Chapter 46: Antiparkinson Agents

Chapter 46: Antiparkinson Agents

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A patient who has Parkinson’s disease takes levodopa and carbidopa. The patient asks the primary care nurse practitioner (NP) why two drugs are necessary. The NP should explain that both drugs are needed to:

ANS:  C

Combining carbidopa with levodopa results in increased concentrations of levodopa in the central nervous system and decreased conversion of levodopa to dopamine in the periphery, where it causes adverse effects. Carbidopa does not prolong the effects of levodopa. The combination does not cause delay in disease progression and does not enhance passage across the blood-brain barrier.

DIF:    Cognitive Level: Applying (Application)                           REF:   505

2. A patient who has Parkinson’s disease and who takes levodopa reports that the drug effects wear off more quickly than before. The primary care NP should:

ANS:  D

When an MAO-B is given, it appears to enhance and prolong the response to levodopa, reducing the wearing-off effect. Carbidopa does not alter this effect. Amantadine is not indicated. Increasing the dose of levodopa is not indicated.

DIF:    Cognitive Level: Applying (Application)                           REF:   505

3. A patient who has Parkinson’s disease takes levodopa and carbidopa. The patient reports experiencing tremors between doses. The primary care NP should:

ANS:  A

Catecholamine O-methyl transferase inhibitors, such as entacapone, are used to prolong the effects of levodopa and help prevent breakthrough tremors that occur before the next dose of levodopa. Amantadine is not indicated. Increasing carbidopa does not have this effect. Increasing the dose of levodopa does not prolong its effects.

DIF:    Cognitive Level: Applying (Application)                           REF:   505

4. A patient who takes levodopa and carbidopa for Parkinson’s disease reports experiencing freezing episodes between doses. The primary care NP should consider using:

ANS:  C

Apomorphine injection is used for acute treatment of immobility known as “freezing.”

DIF:    Cognitive Level: Applying (Application)                           REF:   506