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Levodopa and Carbidopa: In a Nutshell (Nursing)

by Rhonda Lawes

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      Slides 11-06 Parkinsons Levodopa.pdf
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    00:01 So let's wrap up this look.

    00:03 Parkinson's disease is a progressive nervous system disorder that affects a person's ability to control movement.

    00:08 There's an imbalance, remember? There's an imbalance in the neurotransmitter’s acetylcholine and dopamine.

    00:15 Dopamine cannot cross the blood-brain barrier by itself and levodopa is not dopamine but it does increase the dopamine synthesis in the striatum.

    00:25 Remember we have an active transport system that carries levodopa over the blood-brain barrier and so it increases the dopamine synthesis in the striatum because that's where it turn it into dopamine.

    00:36 Carbidopa -- super cool -- levodopa's best friend because it slows down the breakdown of levodopa in the gut and peripheral tissues.

    00:46 Remember that fancy term decarboxylation.

    00:49 Now levodopa plus carbidopa allows for a 75% reduction in the amount of levodopa that we have to give a patient and that's a really good thing because over time, the effects of levodopa and carbidopa will diminish.

    01:05 Most effective for the first two years and then progressively declines after three to five years.

    01:10 Now the drug does really good things but it can also cause more problems that sometimes it's hard to tell the difference between the drug or the disease.

    01:19 So, the patient can develop dyskinesias, difficulty in movement from the medication.

    01:24 Be careful not to have large amounts of dietary protein with the levodopa because the medication will compete for protein transport sites across the blood-brain barrier.

    01:35 So, the medication will be a less effective if the patient eats a high protein meal at the same time, they take the levodopa/carbidopa.

    01:43 Now the adverse effects of levodopa are sadly a little long, right? We have CNS, behavior changes, sleep disturbances, irregular heartbeat, low blood pressure, nausea, vomiting, diarrhea, darkening of their body fluids like urine, sweat and saliva, and it could activate melanoma.

    02:02 They can also induce the dyskinesias so we wanna use it only in caution with first generation antipsychotics and I mean extreme caution with first generation antipsychotics.

    02:15 Like there would have to be a really good reason that you're doing that with very close monitoring and you would not want to give it with MAOI inhibitors.

    02:23 Now, anticholinergic medications will help us increase the effectiveness in dopamine in the brain. Why? Because it blocks those acetylcholine receptors so even though we have extra acetylcholine, by blocking off those receptors it won't be able to wreck its havoc.

    02:38 We can even the odds between acetylcholine and dopamine imbalance in the brain.

    02:43 Thank you for watching our video today.


    About the Lecture

    The lecture Levodopa and Carbidopa: In a Nutshell (Nursing) by Rhonda Lawes is from the course Central Nervous System (CNS) Medications (Nursing).


    Included Quiz Questions

    1. Parkinson's disease is a progressive disease caused by an imbalance of dopamine and acetylcholine in the brain.
    2. Parkinson's disease can be cured by facilitating the transport of carbidopa across the blood-brain barrier.
    3. Medications that treat symptoms of Parkinson's disease focus on increasing the amount of dopamine available to cross the blood-brain barrier.
    4. Once the ideal combination of medications is identified to treat a client with Parkinson's disease, the client will continue to feel the same symptom relief forever.
    1. Carbidopa slows the body's breakdown of levodopa, making more available to cross the blood-brain barrier.
    2. Carbidopa binds with levodopa to facilitate crossing the blood-brain barrier.
    3. Levodopa increases the brain's uptake of carbidopa, which stimulates the release of dopamine.
    4. Levodopa slows the body's breakdown of carbidopa, making more available to cross the blood- brain barrier.

    Author of lecture Levodopa and Carbidopa: In a Nutshell (Nursing)

     Rhonda Lawes

    Rhonda Lawes


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