Chapter 15, Problem 1CS

(1)

Summary Introduction

To determine:

Patients who are taking long-term levodopa treatment often experience an “on-off” phenomenon in symptoms. Explain the physiology behind this phenomenon.

Case summary:

A 62-year-old Parkinson patient is undergoing a surgery to repair an umbilical hernia. He is taking carbidopa-levodopa and selegiline as medication for his Parkinson disease. He has no other health problem other the Parkinson disease. He did not experience any problem for a quiet time but suddenly he is experiencing bad times.

(2)

Summary Introduction

To determine:

Explain the reason for giving selegiline along with carbidopa-levodopa. Ben undergoes the surgery without any difficulties and the following medication orders are noted on the medical record: Continue previous orders for carbidopa-levodopa (Sinemet CR) 1 tablet bid and selegiline (Eldepryl) 5 mg bid (taken with Sinemet CR) Meperidine (Demerol) 10 mg IV every four hours as needed for the pain. Ondansetron (Zofran) 4 mg IV one time if needed for nausea. Begin Entacapone (Comtan) 200 mg bid with each dose of Sinemet.

Case summary:

A 62-year-old Parkinson patient is undergoing a surgery to repair an umbilical hernia. He is taking carbidopa-levodopa and selegiline as medication for his Parkinson disease. He has no other health problem other the Parkinson disease. He did not experience any problem for a quiet time but suddenly he is experiencing bad times.

(3)

Summary Introduction

To determine:

Are there any concerns regarding drug interactions? Explain the answer.

Case summary:

A 62-year-old Parkinson patient is undergoing a surgery to repair an umbilical hernia. He is taking carbidopa-levodopa and selegiline as medication for his Parkinson disease. He has no other health problem other the Parkinson disease. He did not experience any problems for a quiet time but suddenly he is experiencing bad times.

(4)

Summary Introduction

To determine:

What is the purpose of Entacapone?

Case summary:

A 62-year-old Parkinson patient is undergoing a surgery to repair an umbilical hernia. He is taking carbidopa-levodopa and selegiline as medication for his Parkinson disease. He has no other health problem other the Parkinson disease. He did not experience any problem for a quiet time but suddenly he is experiencing bad times.

(5)

Summary Introduction

To determine:

Before administering the entacapone, the nurse review B.history for any potential contraindications. What condition(s) would be a potential contraindication to entacapone.

Case summary:

A 62-year-old Parkinson patient is undergoing a surgery to repair an umbilical hernia. He is taking carbidopa-levodopa and selegiline as medication for his Parkinson disease. He has no other health problem other the Parkinson disease. He did not experience any problem for a quiet time but suddenly he is experiencing bad times.