Antiparkinsonian Drugs

CNS Medications

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Examples

levodopa-carbidoparopinirolepramipexoleselegilinebenztropine

Prefix / Suffix: No consistent suffix

Physiology

Parkinson's disease is caused by loss of dopamine-producing neurons in the substantia nigra, leading to tremor, rigidity, bradykinesia, and postural instability.

Mechanism of Action

Increase dopamine activity (levodopa is a dopamine precursor; agonists stimulate dopamine receptors; MAO-B inhibitors prevent dopamine breakdown) or block acetylcholine to restore dopamine-acetylcholine balance.

Indications

Parkinson's disease
Drug-induced extrapyramidal symptoms (anticholinergics)
Restless legs syndrome (dopamine agonists)

Side Effects / Adverse Effects

Orthostatic hypotension
Nausea, vomiting
Dyskinesias (involuntary movements — long-term levodopa)
'On-off' phenomenon and wearing-off effect
Hallucinations, confusion (especially elderly)
Sleep attacks (dopamine agonists)

Contraindications

Narrow-angle glaucoma
Melanoma (levodopa)
Severe psychiatric disorders

Nursing Considerations

Take levodopa-carbidopa on an empty stomach for best absorption (high-protein meals reduce absorption)
Avoid vitamin B6 supplements with levodopa alone (reduces effectiveness)
Monitor for orthostatic hypotension — rise slowly
Effects may take weeks to appear — encourage adherence
Watch for 'on-off' fluctuations and report to provider
Educate about possible urine/sweat darkening (harmless)
Assess for falls — implement safety measures

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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.