A nurse is discussing motor symptoms with a patient with ...

[sheilaspns]

A nurse is discussing motor symptoms with a patient with Parkinson's disease who has been taking levodopa/carbidopa (Sinemet) and who is now having regular tics. Which statement by the patient indicates understanding of this symptom?
 
  a. I may need to try a lower dose of Sinemet to reduce my tics.
  b. My provider may order clozapine to treat these tics.
  c. These tics are an indication that my dose of Sinemet is too low.
  d. This means I will have to have surgery to stop the symptoms.

Question 2

A nursing student wants to know why a patient who has been taking levodopa (Dopar) for years will now receive levodopa/carbidopa (Sinemet).
 
  The nurse explains the reasons that levodopa as a single agent is no longer available. Which statement by the student indicates a need for further education?
  a. Carbidopa increases the availability of levodopa in the central nervous system.
  b. Carbidopa reduces the incidence of nausea and vomiting.
  c. Combination products reduce peripheral cardiovascular side effects.
  d. Combination products cause fewer dyskinesias and decreased psychosis.

[jliusyl]

Answer to Question 1

ANS: A
Levodopa can cause movement disorders. If they occur, a lower dose of levodopa may be required to alleviate them. Clozapine is an antipsychotic used to treat levodopa-induced psychoses. Movement disorders generally occur as the dose of levodopa increases. Surgery is a last option for treating movement disorders, after amantadine fails.

Answer to Question 2

ANS: D
Adding carbidopa to levodopa does not reduce the incidence of dyskinesias or psychosis. In fact, carbidopa can increase the intensity and the speed of onset of these effects. Carbidopa inhibits decarboxylation of levodopa in the intestine and peripheral tissues, leading to more levodopa in the CNS. Carbidopa cannot cross the blood-brain barrier, so it does not have this action in the CNS. Peripheral side effects are reduced, including nausea, vomiting, and cardiovascular effects.

[sheilaspns]

TY

[jliusyl]

You're welcome