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Chapter 47- Drug Therapy for Parkinson’s Disease and Anticholinergics
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | A 60-year-old male patient has developed a tremor of the right hand with a pill-rolling motion. Upon interviewing the patient, he states he sustained several head injuries playing football. Based on this information, what do you suspect the patient is suffering from? | |
| A) | Seizure disorder | |
| B) | Degenerative joint disease | |
| C) | Amyotrophic lateral sclerosis | |
| D) | Parkinson’s disease | |
| Ans: | D | |
| Feedback: | ||
| Parkinson’s disease is a chronic, progressive, degenerative disorder of the central nervous system characterized by resting tremor, bradykinesia, rigidity, and postural instability. The patient is not experiencing degenerative joint disease. The patient is not showing signs of symptoms of a seizure disorder. The patient has rigidity with tremors, not the signs of muscle weakness that are found in amyotrophic lateral sclerosis. | ||
| 2. | A patient has developed symptoms of rigidity and bradykinesia. Which of the following medications has been linked to secondary parkinsonism? | |
| A) | Haloperidol | |
| B) | Furosemide (Lasix) | |
| C) | Psyllium hydrophilic mucilloid (Metamucil) | |
| D) | Valproic acid (Valproate) | |
| Ans: | A | |
| Feedback: | ||
| Drugs that deplete dopamine stores or block dopamine receptors, including the older antipsychotic drugs (phenothiazines and haloperidol), reserpine, and metoclopramide, can produce movement disorders such as secondary parkinsonism. Furosemide does not deplete dopamine stores. Psyllium does not deplete dopamine stores. Valproic acid does not deplete dopamine stores. | ||
| 3. | A patient is being treated for Parkinson’s disease and has been prescribed both levodopa (L-dopa) and carbidopa (Lodosyn). Why is this course of combination treatment most effective? | |
| A) | Levodopa restores dopamine and carbidopa decreases peripheral breakdown of levodopa. | |
| B) | Levodopa decreases the toxic effects of carbidopa to reduce the extrapyramidal reaction. | |
| C) | Carbidopa increases the peripheral breakdown of levodopa to hasten its onset and peak. | |
| D) | Levodopa and carbidopa, when combined, enhance voluntary movement to improve gait. | |
| Ans: | A | |
| Feedback: | ||
| Levodopa restores dopamine levels and, in combination with carbidopa, decreases the peripheral breakdown of levodopa and allows more to reach the brain. Levodopa does not decrease the toxic effects of carbidopa to reduce the extrapyramidal reaction. Carbidopa does not increase the peripheral breakdown of levodopa to increase its effectiveness. Levodopa and carbidopa combined do not exacerbate abnormal voluntary movement to increase gait. | ||
| 4. | A patient who suffers from Parkinson’s disease is being treated with levodopa/carbidopa. Which of the following disorders will result in the discontinuation of this drug based on a disease-related contraindication? | |
| A) | Human immune deficiency virus | |
| B) | Human papillomavirus | |
| C) | Transient ischemic attacks | |
| D) | Narrow-angle glaucoma | |
| Ans: | D | |
| Feedback: | ||
| Since levodopa can dilate pupils and raise intraocular pressure, it is contraindicated in narrow-angle glaucoma. Levodopa is not contraindicated in patients with human immune deficiency virus. Levodopa is not contraindicated in patients with human papillomavirus. Levodopa is not listed as a contraindication with TIAs. | ||
| 5. | A patient with long-standing Parkinson’s disease has been prescribed entacapone (Comtan). The patient asks the nurse to describe exactly how this medication works. Which of the following responses is most appropriate? | |
| A) | “Entacapone is best given parenterally to relieve symptoms.” | |
| B) | “Entacapone inhibits COMT so that dopamine is active for a longer time.” | |
| C) | “It increases the metabolism of levodopa in the bloodstream.” | |
| D) | “It increases the amount of dopamine that your brain creates.” | |
| Ans: | B | |
| Feedback: | ||
| Entacapone is a COMT inhibitor. COMT plays a role in brain metabolism of dopamine. Entacapone is administered orally, not parenterally. Entacapone does not increase the metabolism of dopamine in the bloodstream. It inhibits the metabolism of levodopa in the blood stream. Entacapone is 90% excreted in the biliary tract and feces and 10% in the urine. | ||
Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $30.00.$20.00Current price is: $20.00.