Chapter 47 Drug Therapy for Parkinson’s Disease and Anticholinergics

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Chapter 47  Drug Therapy for Parkinson’s Disease and Anticholinergics

 

 

Complete chapter Questions And Answers
 

Sample Questions

 

 

1. A 60-year-old male patient has developed a tremor of the right hand with a pill-rolling motion. Upon interviewing the patient, he states he sustained several head injuries playing football. Based on this information, what do you suspect the patient is suffering from?

  1. A)  Seizure disorder
  2. B)  Degenerative joint disease
  3. C)  Amyotrophic lateral sclerosis
  4. D)  Parkinson’s disease

Ans: D
Feedback:
Parkinson’s disease is a chronic, progressive, degenerative disorder of the central nervous system characterized by resting tremor, bradykinesia, rigidity, and postural instability. The patient is not experiencing degenerative joint disease. The patient is not showing signs of symptoms of a seizure disorder. The patient has rigidity with tremors, not the signs of muscle weakness that are found in amyotrophic lateral sclerosis.

2. A patient has developed symptoms of rigidity and bradykinesia. Which of the following medications has been linked to secondary parkinsonism?

  1. A)  Haloperidol
  2. B)  Furosemide (Lasix)
  3. C)  Psyllium hydrophilic mucilloid (Metamucil)
  4. D)  Valproic acid (Valproate)

Ans: A Feedback:

Drugs that deplete dopamine stores or block dopamine receptors, including the older antipsychotic drugs (phenothiazines and haloperidol), reserpine, and metoclopramide, can produce movement disorders such as secondary parkinsonism. Furosemide does not deplete dopamine stores. Psyllium does not deplete dopamine stores. Valproic acid does not deplete dopamine stores.

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3. A patient is being treated for Parkinson’s disease and has been prescribed both levodopa (L-dopa) and carbidopa (Lodosyn). Why is this course of combination treatment most effective?

  1. A)  Levodopa restores dopamine and carbidopa decreases peripheral breakdown of

    levodopa.

  2. B)  Levodopa decreases the toxic effects of carbidopa to reduce the extrapyramidal

    reaction.

  3. C)  Carbidopa increases the peripheral breakdown of levodopa to hasten its onset and

    peak.

  4. D)  Levodopa and carbidopa, when combined, enhance voluntary movement to

    improve gait.

Ans: A

Feedback:

Levodopa restores dopamine levels and, in combination with carbidopa, decreases the peripheral breakdown of levodopa and allows more to reach the brain. Levodopa does not decrease the toxic effects of carbidopa to reduce the extrapyramidal reaction. Carbidopa does not increase the peripheral breakdown of levodopa to increase its effectiveness. Levodopa and carbidopa combined do not exacerbate abnormal voluntary movement to increase gait.

4. A patient who suffers from Parkinson’s disease is being treated with levodopa/carbidopa. Which of the following disorders will result in the discontinuation of this drug based on a disease-related contraindication?

  1. A)  Human immune deficiency virus
  2. B)  Human papillomavirus
  3. C)  Transient ischemic attacks
  4. D)  Narrow-angle glaucoma

Ans: D
Feedback:
Since levodopa can dilate pupils and raise intraocular pressure, it is contraindicated in narrow-angle glaucoma. Levodopa is not contraindicated in patients with human immune deficiency virus. Levodopa is not contraindicated in patients with human papillomavirus. Levodopa is not listed as a contraindication with TIAs.

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