The nurse is teaching a patient who has Parkinson’s disease about the side effects of carbidopa-levodopa. Which statement by the patient indicates a need for further teaching?
A.
“I may experience urinary retention, dry mouth, and constipation.”
B.
“I may feel dizzy at first, but this side effect will go away with time.”
C.
“I should report nightmares and mental disturbances to my provider.”
D.
“I should take the drug with food to increase absorption.”
The Correct Answer and Explanation is:
The correct answer is D. “I should take the drug with food to increase absorption.”
Explanation:
Carbidopa-levodopa is a combination medication commonly prescribed for Parkinson’s disease to manage symptoms like tremors, stiffness, and movement difficulties. Levodopa is converted to dopamine in the brain, helping to alleviate Parkinson’s symptoms, while carbidopa prevents levodopa from being broken down before it reaches the brain, enhancing its effectiveness.
Understanding Side Effects:
- Option A (Urinary Retention, Dry Mouth, Constipation):
- Carbidopa-levodopa can cause anticholinergic side effects such as urinary retention, dry mouth, and constipation. These side effects are common and are linked to the drug’s impact on the autonomic nervous system. This statement reflects accurate knowledge of potential side effects.
- Option B (Dizziness):
- Dizziness, particularly orthostatic hypotension (a drop in blood pressure when standing up), is a known side effect of carbidopa-levodopa. This side effect may diminish as the body adjusts to the medication. Therefore, this statement is also correct and reflects proper understanding.
- Option C (Nightmares and Mental Disturbances):
- Nightmares, hallucinations, and other mental disturbances are potential side effects of carbidopa-levodopa, especially at higher doses or in older adults. Reporting these symptoms to the healthcare provider is crucial as they may require dose adjustment or additional management. This statement is correct and appropriate.
- Option D (Taking the Drug with Food):
- This statement is incorrect and indicates a need for further teaching. While taking carbidopa-levodopa with food can help reduce nausea (a common side effect), it can also interfere with the absorption of the medication, especially if the food is high in protein. Amino acids in proteins can compete with levodopa for transport across the blood-brain barrier, reducing the drug’s effectiveness. Patients are often advised to take the medication either 30 minutes before or one to two hours after a meal to optimize absorption.
Conclusion:
Option D is the correct answer because the patient’s statement about taking the drug with food to increase absorption is inaccurate. Further teaching is necessary to clarify that while taking the medication with food may help with nausea, it can reduce the drug’s effectiveness, particularly if the meal is protein-rich. Proper timing of medication administration in relation to meals is essential for optimal therapeutic outcomes.