Question

PN 200 Fundamentals of Nursing II Parkinson's disease - carbidopa-levodopa TR, a 79-year-old man, was diagnosed with Parkinson's disease 10 years ago. During his early treatment he took selegiline. The drug dosage was increased to alleviate symptoms. 1. How does selegiline alleviate symptoms of Parkinsonism? 2. What dietary changes should be made during the time TR takes selegiline? Because TR developed side effects and adverse reactions to selegiline, the health care provider changed the drug to carbidopa-levodopa. (Sinemet) TR asks the nurse why the drug was changed. 3. What are the similarities and differences between selegiline and Sinemet? 4. What are the advantages of carbidopa-levodopa? TR's family say they know a person with Parkinson's disease who takes an antiviral drug amantadine (Symmetrel). The family asks whether Symmetrel is the same as Sinemet, and if so, whether TR can take that drug instead of the drug containing carbidopa-levodopa. (Note drug classification when answering this question) 5. What is the effect of amantadine on the symptoms of Parkinson's disease? 6. What would be an appropriate response to the family's question concerning the use of Symmetrel for TR? 7. What are the uses for dopamine agonists and COMT inhibitors? 8. Certain anticholinergic drugs may be used to control Parkinsonism symptoms. What is the action of these drugs? What are their side-effects? These anticholinergic drugs are usually prescribed for parkinsonism symptoms resulting from what? (Physiology need be considered to answer this question) Reviewed 1/120

Answer 1

1.

Selegiline is a selective inhibitor that binds with MAO-B. The drug works by binding covalently and blocking dfopamine thus increases the activity and reduces the symptoms of parkinson's disease.

2.

Some food can react with selegiline drug and increase the blood pressure of the individual. TR shoudl avoid consumption of hot dogs, sausages, cooked slice ham, fish, poultry and fresh meat while taking this drug.

3.

TR developed side effects to selegiline and that is why the drug was replaced with levadopa, as this drug contains low dose dompamine inhibitor and same activity with limited side effects.

4.

Levadopa changes into dopamine in brain and helps to enhance control and carbidopa prevents the breakdown of levadopa in blood so more drug cna be utilized in brain, also it has low side effects and prevents nausea and vomiting.