Flash. Neuro. Anti-Parkinson agents

Levodopa (often combined with carbidopa, as in Sinemet) is considered the gold standard.

Carbidopa prevents the peripheral conversion of levodopa to dopamine, allowing more levodopa to reach the brain and reducing peripheral side effects.

Side effects include nausea, dizziness, orthostatic hypotension, dyskinesias, and mood changes.

Over time, the effect of levodopa diminishes before the next dose is due, causing a return of symptoms.

They help control tremors and muscle rigidity.

Patients should avoid foods high in tyramine, such as aged cheeses and cured meats, to prevent hypertensive crisis.

Monitor for therapeutic response, worsening of symptoms, signs of dyskinesias, and adverse drug reactions.

Consistent timing helps maintain steady drug levels, reducing symptom fluctuations and the risk of "off" periods.

Abrupt discontinuation can lead to a rapid worsening of symptoms; thus, any changes should be made under a doctor's guidance.

Entacapone can cause this harmless side effect.

Dietary protein can reduce the absorption of levodopa; thus, spacing protein intake from levodopa doses can be beneficial.

Educate patients to rise slowly from sitting or lying positions and to report any dizziness or fainting episodes.

Dopamine agonists may be used as first-line treatment in younger patients to delay the initiation of levodopa and thus delay levodopa-associated complications.

Drugs like amantadine can cause visual changes, and regular ophthalmologic check-ups can monitor for any concerning alterations.

Encouraging a high-fiber diet, adequate fluid intake, and use of stool softeners as ordered can help manage constipation.

Taking levodopa/carbidopa on an empty stomach can enhance its absorption and therapeutic effect. Food, especially protein-rich meals, can interfere with its absorption in the small intestine.

The nurse should educate the patient that levodopa/carbidopa may take several weeks to show its full therapeutic effect and advise against stopping the medication abruptly, as this can worsen symptoms. All changes to medication should be done under a physician's guidance.

Nurses should educate patients about the potential for "on-off" phenomena — periods when the medication is effective ("on" time) interspersed with periods when the medication's effect wears off and symptoms return ("off" time). They should be advised to report these fluctuations to their healthcare provider, as medication adjustments might be necessary.

Dry mouth, blurred vision, urinary retention, constipation, and confusion.

Nurses should monitor patients for signs of hallucinations, agitation, or delusional thinking. Patients and caregivers should be educated about these potential side effects and instructed to report them immediately if they occur. In some cases, dose adjustments or additional medications might be necessary.