The nurse is assessing an older patient with Parkinson's disease ...

[bobypop]

The nurse is assessing an older patient with Parkinson's disease who was started on entacapone 1 week ago. The patient has a history of coronary artery disease and takes an antihypertensive and aspirin.
 
  Which information would support the need for a reduction in medication dosage by the health care provider?
  a. Constipation
  b. Brownish orange urine
  c. Drowsiness
  d. Dizziness

Question 2

What is the pharmacologic action of entacapone, a potent catechol O methyl transferase (COMT) inhibitor?
 
  a. Slows the deterioration of dopaminergic nerve cells
  b. Inhibits the relative excess of dopaminergic activity
  c. Reduces the destruction of dopamine in peripheral tissues
  d. Enhances the cholinergic symptoms of Parkinson's disease

[katara]

Answer to Question 1

ANS: D
Dizziness is a symptom of orthostatic hypotension; dosages may need to be altered. Constipation is an expected adverse effect of this medication. Brownish orange urine is an expected adverse effect of this medication. Drowsiness is an expected adverse effect that occurs when therapy is initiated.

Answer to Question 2

ANS: C
Entacapone, a COMT inhibitor, reduces dopamine destruction in peripheral tissues. This significantly increases the amount of dopamine available to reach the brain. Entacapone, when used with carbidopa levodopa therapy, results in more constant dopaminergic stimulation. Entacapone is not effective when used alone. Entacapone does not affect the nerve cells but blocks enzymes that break down levodopa. Parkinson's disease is characterized by a relative deficit of dopaminergic activity. Entacapone does not affect cholinergic symptoms of Parkinson's disease.

[bobypop]

Wow, this really help

[sultansheikh]

Excellent