NU 150 - Galen - Pharm Test 4
Questions and Answers
Sinemet (levodopa-carbidopa) - actions - CORRECT ANSWER-Used to treat
Parkinson's
Dopaminergic Drug
Levodopa crosses the BBB (blood brain barrier) in small amounts→ converted into
dopamine (pleasure)
Levodopa if given with carbidopa, ↑ drug level that reaches the brain
Carbidopa has no affect when given alone
Sinemet is the combination of Levodopa/Carbidopa.
Carbidopa-conserves more dopamine
Levodopa-leaves more dopamine in the brain
Sinemet (levodopa-carbidopa) - Toxic ADRs - CORRECT ANSWER-Face or eyelid
twitching
Tongue perfusion
Face grimacing
Means toxic levels of dopamine let HCP know
Sinemet (levodopa-carbidopa) - Patient Teaching - CORRECT ANSWER-Slow onset
2-6 weeks to become effective
Slow position changes
Red, brown, urine, sweat and saliva=normal
No high protein meals
LEAVE-odopa-leave protein meals
CARB-odopa- carb it up
Not an elimination of tremors or rigidity just DECREASES
Never stop abruptly
Taken lifelong
Levodopa ((Larodopa)) - actions - CORRECT ANSWER-Used in management of
Parkinson's
Levodopa crosses the BBB in small amounts→ converted into dopamine.
levodopa if given with carbidopa, ↑ drug level that reaches the brain
Levodopa ((Larodopa)) - ADR - CORRECT ANSWER-During the early treatment
with Levodopa and Carbidopa adverse reactions are usually not seen.
GENERAL ADRs: dry mouth, dysphagia, anorexia, N/V, abdominal pain,
constipation, hand tremor, ↑headache and dizziness.
Most serious and frequent adverse drug reaction with Levodopa:
Choreiform movements→ involuntary twitching of the limbs or facial muscles.
Dystonic movements→ spasms that affect the tongue, jaw, eyes, and neck.
Levodopa ((Larodopa)) - drug interaction - CORRECT ANSWER-Levodopa may
interact with many types of drugs.
Vit B6 (pyridoxine): ↓effect of levodopa, no interaction effect if used with carbidopa.
, Phenytoin (Anticonvulsant Drugs) - uses - CORRECT ANSWER-Hydantoins:
phenytoin (DILANTIN)
most commonly prescribed.
some individuals respond well to one drug therapy, but in others, a combination of
anticonvulsants is needed.
also used for other diseases, for example bipolar, neuropathic pain, and anxiety
Adjustments to the medication may need to be made when the patient is under lots
of stress, severe illness, or when other drugs are being taken in combination with the
anticonvulsants.
Phenytoin (Anticonvulsant Drugs) - toxic ranges - CORRECT ANSWER-10-20
mcg/dl Therapeutic range
Below 10-seizure risk
Over 20 toxic risk-hold med and notify HCP
Routine blood tests
Take med same time daily same time narrow therapeutic range
Early signs to report to HCP for toxicity
Ataxia (unsteady gait)
Slurred speech
Hand tremor
Phenytoin (Anticonvulsant Drugs) - ADR - CORRECT ANSWER-ADRs
• Nystagmus-involuntary movement of the eyeball
Ataxia-loss of control of voluntary movements, mainly gait
Slurred speech
Skin Rash, fatigue, and dyspnea (priority)
N/V
Gingival hyperplasia-overgrowth of gum tissue (gums bleeding is normal). Important
to inform the dentist that you are on Phenytoin (Dilantin).
Hepatotoxicity- liver toxic
Phenytoin (Anticonvulsant Drugs) -Contraindications - CORRECT ANSWER-
Contraindications: hypersensitivity, heart problems, pregnancy, and lactation.
DO NOT mix with other CNS depressants, e.g., narcotics, alcohol
Precautions: liver & kidney disease, neurological disorders.'
Interactions w/ different drugs. It is important to talk with your PHCP about other
medications to see if an interaction will occur.
No stopping abruptly
Phenytoin (Anticonvulsant Drugs) - adverse reactions - CORRECT ANSWER-
Drowsiness: common ADR→ assist with ambulation to prevent falls from occurring.
blood dyscrasias (abnormal) → lab tests done routinely to monitor and watch for any
problems.
Hypersensitivity, SJS, hyperglycemia, gingival hyperplasia/gingivitis
Signs of toxicity: slurred speech, ataxia, lethargy, dizziness, N/V.
Allopurinol (Uric Acid Inhibitors) - uses - CORRECT ANSWER-Gout = A form of
arthritis characterized by severe pain, redness, and tenderness in joints.
Decreased the production of uric acid→ ↓the level of serum uric acid and the
deposits of urate crystals in the joints. = uric acid reducer
