Parkinsonism: Symptoms And Diagnosis! Trivia Knowledge Quiz

Carbidopa is used in combination with levodopa to enhance its effectiveness and reduce peripheral adverse effects. Carbidopa inhibits the enzyme that breaks down levodopa in the bloodstream, allowing more of it to reach the brain. This reduces the required dose of levodopa, thereby minimizing the occurrence of side effects such as nausea, hypotension, and cardiac arrhythmias. Amantadine and bromocriptine are alternative medications for Parkinson's disease, but they do not specifically address the peripheral adverse effects of levodopa. Entacapone is a COMT inhibitor that prolongs the effects of levodopa but does not directly reduce its adverse effects.

Levodopa causes postural hypotension. This means that when taking levodopa, a person may experience a drop in blood pressure upon standing up, leading to dizziness or fainting. This side effect is commonly seen in patients with Parkinson's disease who are treated with levodopa. It is important for healthcare providers to monitor blood pressure and adjust the dosage of levodopa accordingly to minimize the risk of postural hypotension.

Selegiline is the most appropriate drug to rescue the patient because it is a selective monoamine oxidase B (MAO-B) inhibitor. MAO-B inhibitors increase the levels of dopamine in the brain by blocking the breakdown of dopamine, thereby enhancing the effects of levodopa-carbidopa therapy. This can help to alleviate off-periods of akinesia in patients with parkinsonism. Apomorphine is a dopamine agonist that can also be used to rescue patients experiencing off-periods, but it is typically used when MAO-B inhibitors are ineffective or not tolerated. Benztropine is an anticholinergic agent that can be used to manage tremors in parkinsonism, but it is not the most appropriate drug for rescuing off-periods. Carbidopa is already being used in combination with levodopa and is not indicated as a rescue medication.

Bromocriptine is an anti-Parkinson drug that may cause peripheral vasospasm. Vasospasm is the narrowing of blood vessels, which can reduce blood flow to certain areas of the body. This side effect of bromocriptine can lead to symptoms such as cold hands and feet, numbness, and pain in the affected areas. It is important for patients taking bromocriptine to be aware of this potential side effect and to report any symptoms to their healthcare provider.

Other drugs that activate dopamine receptors can exacerbate dyskinesia in a patient taking levodopa. This means that if the patient is taking other medications that stimulate dopamine receptors, it can worsen the involuntary muscle jerks that the patient is experiencing. Therefore, caution should be taken when prescribing other drugs that activate dopamine receptors to patients being treated with levodopa for parkinsonism.