NUR 2474 Pharm Eaxam 1 Study Guide
(New 2026/ 2027 Update) Questions &
Answers {Grade A} 100% Correct (Verified
Solutions)
Baclofen therapy (adverse effects) - correct answer b. Adverse effects:
i. Withdrawal
ii. GI symptoms (nausea, constipation) iii. Urinary retention
iv. Miss one dose, cause seizures!
Baclofen therapy (considerations) - correct answer c. Considerations: There is no
antidote for an OD. It is a CNS depressant. Withdrawal needs to be gradual or there is a
risk of serious complication. Do not use with alcohol!
Baclofen therapy (cautions) - correct answer d. Caution:
seizure patients and renal impairment.
e. May take with food to avoid GI upset.
Levodopa/Carbidopa what type of agent? - correct answer Dopaminergic agent
,Parkinson's Disease - correct answer 1. Incurable, cannot be slowed down, chronic
degenerative disease.
2. Treatment is to treat symptoms!
3. Dyskinesias (motor symptoms).
4. Akinesias (nonmotor symptoms).
5. Goal for treatment is to improve patients ability to do ADLs.
Levodopa/Carbidopa Action - correct answer b. Action
i. Levodopa is only given with carbidopa.
ii. Given PO.
iii. Rapid absorption from small intestine.
iv. Reduces symptoms by increasing dopamine synthesis in the striatum.
v. Enters brain via active transport system that carries it across the blood-brain
barrier. vi. In the brain: uptake into the remaining dopaminergic nerve terminals that
remain in the striatum.
vii. Levodopa, no direct effect on its own, converts to dopamine. 1. Prodrug form is
converted to dopamine.
,viii. Levodopa helps to restore a proper balance between dopamine and ACh.
Levodopa/Carbidopa side effects and interventions - correct answer i. Nausea and
vomiting (neurotransmitter levels)- Giving additional carbidopa (without levodopa) can
help reduce N/V.
ii. Activation of dopamine receptors in the chemoreceptor trigger zone of the medulla.
iii. Low initial doses and administration with food can reduce therapeutic effects by
decreasing levodopa absorption.
- Cardiovascular (check vital signs), Postural hypotension (increase salt and water
intake to avoid hypotension and hyponatremia), Psychosis, Visual hallucinations, Vivid
dreams/nightmares, Paranoid ideation.
1. Caused by activation of dopamine receptors. - Symptoms can be reduced by lowering
levodopa dosage. This will reduce beneficial effects as well.
- Dyskinesias (some just annoying, others can be disabling)
1. Reduce dosage.
2. Amantadine.
3. Surgery and electrical stimulation. xii. Darkens sweat and urine.
, xiii. Even with treatment, usually at about 5 years, the patient will go back to starting
point/baseline, body builds tolerance and increase.
xiv. Adding an MAO-B Inhibitor slows the breakdown of levodopa and dopamine in the
brain, and may boost the effect of levodopa.
xv. Dopaminergic Drugs.
xvi. Dopamine inhibits motor movement while ACh stimulates motor movement.
xvii. Dopamine agonist 1. Stops dopamine production.
2. High protein foods decrease therapeutic effect.
xviii. HTN crisis with MAOI.
xix. Increase salt and water intake to avoid hyponatremia and hypotension.
xx. Avoid vitamin b6 supplements because it decreases amount that reaches the brain.
xxi. Activates malignant melanoma- important to perform a careful skin assessment of
patients and ask about history of skin cancers. xxii. CNS effects
1. Anxiety and agitation 2. Memory and cognitive impairments 3. Insomnia and
nightmares
4. Problems with impulse control
a) Behavior changes associated with promiscuity, gambling, binge eating, a
(New 2026/ 2027 Update) Questions &
Answers {Grade A} 100% Correct (Verified
Solutions)
Baclofen therapy (adverse effects) - correct answer b. Adverse effects:
i. Withdrawal
ii. GI symptoms (nausea, constipation) iii. Urinary retention
iv. Miss one dose, cause seizures!
Baclofen therapy (considerations) - correct answer c. Considerations: There is no
antidote for an OD. It is a CNS depressant. Withdrawal needs to be gradual or there is a
risk of serious complication. Do not use with alcohol!
Baclofen therapy (cautions) - correct answer d. Caution:
seizure patients and renal impairment.
e. May take with food to avoid GI upset.
Levodopa/Carbidopa what type of agent? - correct answer Dopaminergic agent
,Parkinson's Disease - correct answer 1. Incurable, cannot be slowed down, chronic
degenerative disease.
2. Treatment is to treat symptoms!
3. Dyskinesias (motor symptoms).
4. Akinesias (nonmotor symptoms).
5. Goal for treatment is to improve patients ability to do ADLs.
Levodopa/Carbidopa Action - correct answer b. Action
i. Levodopa is only given with carbidopa.
ii. Given PO.
iii. Rapid absorption from small intestine.
iv. Reduces symptoms by increasing dopamine synthesis in the striatum.
v. Enters brain via active transport system that carries it across the blood-brain
barrier. vi. In the brain: uptake into the remaining dopaminergic nerve terminals that
remain in the striatum.
vii. Levodopa, no direct effect on its own, converts to dopamine. 1. Prodrug form is
converted to dopamine.
,viii. Levodopa helps to restore a proper balance between dopamine and ACh.
Levodopa/Carbidopa side effects and interventions - correct answer i. Nausea and
vomiting (neurotransmitter levels)- Giving additional carbidopa (without levodopa) can
help reduce N/V.
ii. Activation of dopamine receptors in the chemoreceptor trigger zone of the medulla.
iii. Low initial doses and administration with food can reduce therapeutic effects by
decreasing levodopa absorption.
- Cardiovascular (check vital signs), Postural hypotension (increase salt and water
intake to avoid hypotension and hyponatremia), Psychosis, Visual hallucinations, Vivid
dreams/nightmares, Paranoid ideation.
1. Caused by activation of dopamine receptors. - Symptoms can be reduced by lowering
levodopa dosage. This will reduce beneficial effects as well.
- Dyskinesias (some just annoying, others can be disabling)
1. Reduce dosage.
2. Amantadine.
3. Surgery and electrical stimulation. xii. Darkens sweat and urine.
, xiii. Even with treatment, usually at about 5 years, the patient will go back to starting
point/baseline, body builds tolerance and increase.
xiv. Adding an MAO-B Inhibitor slows the breakdown of levodopa and dopamine in the
brain, and may boost the effect of levodopa.
xv. Dopaminergic Drugs.
xvi. Dopamine inhibits motor movement while ACh stimulates motor movement.
xvii. Dopamine agonist 1. Stops dopamine production.
2. High protein foods decrease therapeutic effect.
xviii. HTN crisis with MAOI.
xix. Increase salt and water intake to avoid hyponatremia and hypotension.
xx. Avoid vitamin b6 supplements because it decreases amount that reaches the brain.
xxi. Activates malignant melanoma- important to perform a careful skin assessment of
patients and ask about history of skin cancers. xxii. CNS effects
1. Anxiety and agitation 2. Memory and cognitive impairments 3. Insomnia and
nightmares
4. Problems with impulse control
a) Behavior changes associated with promiscuity, gambling, binge eating, a
