A nursing student wants to know why a patient who has been taking levodopa (Dopar) for years will now receive levodopa/carbidopa (Sinemet)
The nurse explains the reasons that levodopa as a single agent is no longer available. Which statement by the student indicates a need for further education?
a. "Carbidopa increases the availability of levodopa in the central nervous system."
b. "Carbidopa reduces the incidence of nausea and vomiting."
c. "Combination products reduce peripheral cardiovascular side effects."
d. "Combination products cause fewer dyskinesias and decreased psychosis."
ANS: D
Adding carbidopa to levodopa does not reduce the incidence of dyskinesias or psychosis. In fact, carbidopa can increase the intensity and the speed of onset of these effects. Carbidopa inhibits decarboxylation of levodopa in the intestine and peripheral tissues, leading to more levodopa in the CNS. Carbidopa cannot cross the blood-brain barrier, so it does not have this action in the CNS. Peripheral side effects are reduced, including nausea, vomiting, and cardiovascular effects.
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