A patient on levodopa (Dopar) for Parkinson's disease comes to the emergency department complaining of a severe headache
The vital signs are: temperature 98.8° F, pulse 92/minute, blood pressure 202/107, and respirations 18/minute. A nurse should be most concerned if which of the following drugs is on the patient's current list?
a. Carbidopa
b. Phenelzine (Nardil)
c. Citalopram (Celexa)
d. Amitriptyline
ANS: B
Levodopa can cause a hypertensive crisis if administered to an individual taking a monoamine oxidase inhibitor, such as phenelzine. The drug-to-drug interaction caused by these medications can cause massive vasoconstriction that leads to a hypertensive crisis, which is clearly what this patient is experiencing.
Carbidopa increases the beneficial effects of levodopa.
Celexa is a selective serotonin reuptake inhibitor; it does not cause hypertensive crisis when taken concurrently with levodopa, although it can decrease levodopa's effectiveness.
Amitriptyline is a tricyclic antidepressant; it does not promote hypertensive crisis when taken with levodopa, but it can decrease levodopa's effectiveness.
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