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Drugs for Parkinson disease

Bridgeman, Mary Barna PharmD, BCPS, BCGP; Dalal, Kavitha S. PharmD

doi: 10.1097/01.NURSE.0000549729.45434.8e
Department: Drug Challenge
Free

Mary Barna Bridgeman is a clinical associate professor at Rutgers University Ernest Mario School of Pharmacy in Piscataway, N.J. Kavitha S. Dalal is a critical care pharmacist at Virtua in Marlton, N.J.

Unless otherwise specified, the information in the preceding summaries applies to adults, not children. Consult the package insert for information about each drug's safety during pregnancy and breastfeeding. Also consult a pharmacist, the package insert, or a comprehensive drug reference for more details on precautions, drug interactions, and adverse reactions.

CAN YOU IDENTIFY these new medications and medication formulations for treatment of Parkinson disease (PD) or symptoms related to PD? Match each drug in Section I with a description in Section II.

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Section I

_____ 1. Duopa (AbbVie Inc.)

_____ 2. Gocovri (Adamas Pharma LLC)

_____ 3. Nuplazid (Acadia Pharmaceuticals Inc.)

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Section II

a. carbidopa and levodopa. This enteral suspension is indicated to treat motor fluctuations in patients with advanced PD. It is administered over the course of a 16-hour enteral feed via either a naso-jejunal tube for short-term use or a percutaneous endoscopic gastrostomy with a jejunal tube for long-term use. Remove each drug-containing cassette from the refrigerator at least 20 minutes before administration to ensure it reaches proper temperature for medication delivery. Teach patients to notify their prescriber immediately if they experience abdominal pain or prolonged constipation, nausea, vomiting, fever, or blood in the stool.

b. pimavanserin. An atypical antipsychotic, this oral medication is approved specifically for treatment of hallucinations and delusions associated with PD psychosis. It is contraindicated in older adults with dementia-related psychosis unrelated to PD psychosis and should be avoided in patients with known QT prolongation and in those taking other drugs known to prolong the QT interval. The most common adverse reactions are peripheral edema and confusional state.

c. amantadine extended-release capsules. Amantadine is indicated for treatment of dyskinesia in patients with PD receiving levodopa-based therapy, with or without concomitant dopaminergic medications. This extended-release capsule preparation can be administered by mouth once daily at bedtime. It is contraindicated for use in patients with end-stage renal disease. The most common adverse reactions include hallucination, dizziness, dry mouth, peripheral edema, constipation, and orthostatic hypotension.

ANSWERS: 1a, 2c, 3b

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