Deck 15: Antiparkinson Drugs

Question 1

The prescriber writes this order, "Give amantadine (Symmetrel) 100 mg per PEG tube twice a day." The medication is available in a liquid form with a concentration 50 mg/5 mL. Identify how many milliliters the nurse will give with each dose. _______

Answer 1

10 mL
50 mg:5 mL :: 100 mg:x mL
(50 × x) = (5 × 100); 50x = 500; x = 10 mL

Question 2

The nurse is developing a care plan for a patient who is taking an anticholinergic drug. Which human needs statement would be appropriate for this patient?

A) Altered gastrointestinal elimination (diarrhea)
B) Altered urinary elimination
C) Altered safety needs, risk for infection
D) Altered sleep needs

Answer 2

Altered urinary elimination

Question 3

A patient has been treated with antiparkinson medications for 3 months. What therapeutic responses should the nurse look for when assessing this patient?

A) Decreased appetite
B) Gradual development of cogwheel rigidity
C) Newly developed dyskinesias
D) Improved ability to perform activities of daily living

Answer 3

Improved ability to perform activities of daily living

Question 4

A patient who has been on levodopa therapy for a year has a new order for a catechol ortho-methyltransferase (COMT) inhibitor as part of treatment for Parkinson's disease. The nurse recognizes that which of these is an advantage of this drug class?

A) It has a shorter duration of action.
B) It causes less gastrointestinal distress.
C) It has a slower onset than traditional Parkinson's disease drugs.
D) It reduces the wearing-off phenomenon.

Question 5

The nurse is assessing the medication history of a patient with a new diagnosis of Parkinson's disease. Which condition is a contraindication for the patient, who will be taking entacapone (Comtan)?

A) Glaucoma
B) Seizure disorder
C) Liver failure
D) Benign prostatic hyperplasia

Question 6

When a patient is taking an anticholinergic such as benztropine (Cogentin) as part of the treatment for Parkinson's disease, the nurse should include which information in the teaching plan?

A) Minimize the amount of fluid taken while on this drug.
B) Discontinue the medication if adverse effects occur.
C) Take the medication on an empty stomach to enhance absorption.
D) Use artificial saliva, sugarless gum, or hard candy to counteract dry mouth.

Question 7

Carbidopa-levodopa (Sinemet) is prescribed for a patient with Parkinson's disease. The nurse informs the patient that which common adverse effects can occur with this medication?

A) Drowsiness, headache, weight loss
B) Dizziness, insomnia, nausea
C) Peripheral edema, fatigue, syncope
D) Heart palpitations, hypotension, urinary retention

Question 8

A patient taking entacapone (Comtan) for the first time calls the clinic to report a dark discoloration of his urine. After listening to the patient, the nurse realizes that what is happening in this situation?

A) This is a harmless effect of the drug.
B) The patient has taken this drug along with red wine or cheese.
C) The patient is having an allergic reaction to the drug.
D) The ordered dose is too high for this patient.

Question 9

While a patient is receiving drug therapy for Parkinson's disease, the nurse monitors for dyskinesia, which is manifested by which finding?

A) Rigid, tense muscles
B) Difficulty in performing voluntary movements
C) Limp extremities with weak muscle tone
D) Confusion and altered mental status

Question 10

When treating patients with medications for Parkinson's disease, the nurse knows that the wearing-off phenomenon occurs for which reason?

A) There are rapid swings in the patient's response to levodopa.
B) The patient cannot tolerate the medications at times.
C) The medications begin to lose effectiveness against Parkinson's disease.
D) The patient's liver is no longer able to metabolize the drug.

Question 11

When assessing the medication history of a patient with a new diagnosis of Parkinson's disease, which conditions are contraindications for the patient who will be taking carbidopa-levodopa?

A) Angle-closure glaucoma
B) History of malignant melanoma
C) Hypertension
D) Benign prostatic hyperplasia
E) Concurrent use of monoamine oxidase inhibitors (MAOIs)

Question 12

A patient has been given a prescription for levodopa-carbidopa (Sinemet) for a new diagnosis of Parkinson's disease. The patient asks the nurse, "Why are there two drugs in this pill?" The nurse's best response reflects which fact?

A) Carbidopa allows for larger doses of levodopa to be given.
B) Carbidopa prevents the breakdown of levodopa in the periphery.
C) There are concerns about drug-food interactions with levodopa therapy that do not exist with the combination therapy.
D) Carbidopa is the biologic precursor of dopamine and can penetrate into the central nervous system.

Question 13

A patient has been taking selegiline (Eldepryl) for a few months, and recently the prescriber increased his dose to 20 mg/day. Today, during his office visit, he tells the nurse that he forgot and had a beer with dinner last evening, and "felt awful." What did the patient most likely experience?

A) Hypotension
B) Hypertension
C) Urinary discomfort
D) Gastrointestinal upset