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ANTIPARKINSO

NS DRUGS
Bonoan, Kiana
Casayuran, Hannah Mae
Del Carmen, Nichole
Soriano, Joana Christina

Overview:

Parkinson's
is a disorder ofdisease
the brain characterized
by shaking (tremor) and difficulty with
walking, movement and coordination.
the disease is associated with damage
to a part of the brain that is involved
with movement

Sinemet (carbidopa-levodopa)
Is a combination of carbidopa and
levodopa for the treatment of
Parkinson's disease and syndrome
Carbidopa - an inhibitor of aromatic
amino acid decarboxylation
Levodopa - an aromatic amino acid

CASE:
Sam Snow, age 80, has
Parkinson's disease and has
been taking Sinemet for 10
years. He wants to discontinue
the drug because he says it's
not helping him anymore. He
needs
the
following
information

1. He should be told the following EXCEPT


a. Tolerance can develop
b. He can increase dose
c. M.D. may change medicine
d. Withdrawal increases symptoms

ANSWER: He can increase dose

"He can increase dose"


Physician is a qualified healthcare
practitioner
in
the
form
of
instructions that govern the plan of
care for an individual patient.

Tolerance can developed due


to long term treatment. It may
end up experiencing an
increase withdrawal symptoms
and M.D may change the

2. When Sinemet loses effectiveness, other

drugs can be combined with it for a better effect.


Which is not a drug combined with Sinemet?
a. Requip (ROPINIROLE)
b. Mirapex (PRAMIPEXOLE)
c. Tegretol (CARBAMAZEPINE)
d. Parlodel (BROMOCRIPTINE)

ANSWER: Tegretol

Tegretol (CARBAMAZEPINE)
Because Tegretol is an anticonvulsant
drug, there will be a possible drug
interaction with Sinemet. It works by
decreasing nerve impulses that causes
seizures and pain.

Requip, Mirapex and Parlodel are all


dopamine agonists. These medicines
might be taken alone or in combination
with Sinemet. They do not have the
same risks of long-term complications
as levodopa therapy, dopamine
agonists are often the first choice of
treatment for Parkinsons Disease.

3. All of the following can be side effects of Sinemet


EXCEPT:
a. Dizziness
b. Constipation
c. Involuntary movements
d. Agitated confusion

ANSWER: ALL SIDE EFFECTS OF SINEMET

Dizziness, agitated confusion are the


most common side effect of the drug.
Constipation is
less common. While
involuntary movements is due to
levodopa has a characteristics as
choreiform.
As your body adjust to the medicine
during the treatment these side effect
may not occur in the succeeding years

4. All of the following may antagonize


sinemet or potentiate side effects except:
A. Antihypertensives + Sinemet
(Levidopa/Carbidopa)= Symptomatic
postural hypotension
B. Sinemet + Iron= Decrease in the
absorption of sinemet in the body
C.Sinemet + Phenytoin= Decrease in
effectiveness or absorption of sinemet
D. Sinemet + Aspirin= no known interaction

Aspirin is the drug that will not


antagonize or potentiate side effects
with Sinemet

Antihypertensives can decrease the


absorption of sinemet causing postural
hypotension since antihypertensive
decrease blood pressure, and heart rate

5.Selegiline is sometimes combined with


sinemet, there are serious interactions with
selegiline and the following medications
A. Selegiline + Meperidine (Demerol)= an increase of serotonin
except:
levels
B. Selegiline + Amantadine= Both are used for parkinsonism
C. Selegiline + Tricyclics = Can cause Serotonin syndrome
D. Selegiline + SSRI = Can cause Serotonin syndrome

Selegiline and Amantadine are the


safe choice since both drugs are used
for parkinsonism

Selegiline combined with anti-depressants


like SSRIs and tricyclics and opioid
analgesics such as meperidine can cause
increase of serotonin levels in the body

Serotonin syndrome occurs when you take


medications that cause high levels of the
chemical serotonin to accumulate in your
body.
Serotonin is a chemical your body produces
that's needed for your nerve cells and brain
to function. But too much serotonin causes
symptoms that can range from mild
(shivering and diarrhea) to severe (muscle
rigidity, fever and seizures).

Symptoms of serotonin syndrome

Confusion
Agitation or restlessness
Dilated pupils
Headache
Changes in blood pressure and/or temperature
Nausea and/or vomiting
Diarrhea
Rapid heart rate
Tremor
Loss of muscle coordination or twitching muscles
Shivering and goose bumps
Heavy sweating

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