Author Question: A patient with Parkinson's disease has been achieving effective symptom control with levodopa ... (Read 64 times)

dalyningkenk · **on:** Jul 23, 2018

A patient with Parkinson's disease has been achieving effective symptom control with levodopa (Dopar) but complains that the symptoms begin to return before it is time for the next dose. The drug just wears off, he states.

The nurse should anticipate that the prescriber will order the pa-tient to a. take the levodopa at shorter dosing intervals.
b. start taking a drug that reduces levodopa's half-life.
c. take levodopa at longer dosing intervals.
d. increase the dose to increase receptor binding.

Question 2

An obese patient is admitted to the unit. The blood glucose level is 379, urinalysis reveals glycosuria, blood pressure is 178/99, and the patient complains of muscle aches and weakness.

The patient also exhibits a moon face and buffalo hump. The nurse recognizes these signs and symptoms as ___________________ ___ and anticipates ___________________ __. a. Graves' disease; treatment directed at the cause
b. Addison's disease; administration of fludrocortisone
c. Cushing's syndrome; treatment directed at the cause
d. diabetes; insulin replacement therapy

Dnite · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

A
Gradual loss (wearing off) develops near the end of the dosing interval and simply indicates that drug levels have declined to a subtherapeutic value. Wearing off can be minimized by shortening the dosing interval.
Giving a drug that prolongs levodopa's plasma half-life and giving a direct-acting dopamine agonist would be effective; giving a drug that reduces levodopa's half-life would not.
Levodopa should be taken at shorter dosing intervals, not longer ones.
Increasing the dose does not increase receptor binding. The availability of receptor binding makes a difference, and as does the drug's affinity for the receptor.

Answer to Question 2

C
Cushing's syndrome is manifested by obesity, hyperglycemia, glycosuria, hypertension, fluid and electrolyte disturbances, osteoporosis, muscle weakness, myopathy, hirsutism, a moon face, and a buffalo hump. Treatment is directed at the cause.
Graves' disease is not associated with the adrenal gland, but rather with the thyroid gland.
Addison's disease is manifested by weakness, emaciation, hypoglycemia, and increased pigmen-tation of the skin and mucous membranes.
Diabetes is manifested in many ways but not by a moon face or buffalo hump.