NR 568 (NR568) Final Exam (Latest 2026/2027 Update) Advanced Pharmacology for the Adult-Gerontology Primary Care Nurse Practitioner Study Guide| Grade A – Chamberlain.

NR 568 (NR568) Final Exam (Latest 2026/2027
Update) Advanced Pharmacology for the Adult-
Gerontology Primary Care Nurse Practitioner
Study Guide| Grade A – Chamberlain.
Question:

Dopamine agonists? i,-




Answer:

may cause excessive daytime sleepiness in 50% of PD patients. Sudden
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sleep attacks are potentially dangerous during driving.
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Question:

Parkinson's disease (PD)? i,- i,-




Answer:

a slow, progressive neurodegenerative disease that affects the
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extrapyramidal motor system. Specifically, the dopamine neurons in the
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substantia nigra are primarily affected, and degeneration of these neurons
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disrupts effortless motor control. The hallmark features of PD are resting
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tremors, rigidity, akinesia/bradykinesia, and postural instability. There is no
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cure, and treatment targets to control symptoms and maintain the quality
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of life (QOL) or functioning
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,Question:
Levodopa, a dopamine precursor, is the most effective medication for PD.?
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Answer:

Initiating pharmacotherapy for PD remains controversial. Patients
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experience approximately 50% improvement in motor function with
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levodopa compared to 30% with dopamine agonists. Increased gastric
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acid, food, or anticholinergic medications delay gastric emptying and
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decrease the amount of levodopa absorbed. Antacids improve levodopa
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absorption, whereas iron products bind levodopa and reduce
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bioavailability. An extended-release (ER) formulation of levodopa (Rytary)
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is also approved, but the ideal time to initiate this medication has not
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been determined.
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Question:

Dopamine agonists? i,-




Answer:
bind to postsynaptic dopamine receptors and are practical for PD initial
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therapy. The advantages of dopamine agonists are most effective in the
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advanced stages of the disease. These medications can be added to
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levodopa to minimize variations in response, improve wearing-off
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symptoms, decrease in levodopa dose, and improve overall functioning
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Question:
MAO-B inhibitors? i,-

,Answer:
are recommended for treatment of PD in conjunction with levodopa to
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inhibit the breakdown of both dopamine and levodopa in the brain; which
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ultimately increases levodopa in the brain and enhances its effect. MAOIs
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work through selective blockade of dopamine metabolism through MAO-
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B, particularly for those patients who choose to delay dopaminergic
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medications and use MAO-B inhibitors as initial therapy. Combining these
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medications with levodopa in early treatment may delay motor
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complications. Neuroprotection is an additional benefit for using MAOIs
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when medication therapy is initiated early in the disease process (
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Question:
COMT inhibitors? i,-




Answer:

Inhibitors of COMT, an enzyme that catalyzes levodopa to 3-o-
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methyldopa, are added to levodopa/carbidopa to increase levodopa
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concentrations, extend its half-life, and decrease wearing off time
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Question:

Amantadine (Symmetrel)? i,-




Answer:

Amantadine (Symmetrel) is an N-methyl-D-aspartate (NMDA)-receptor
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antagonist that blocks glutamate (excitatory neurotransmitter)
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transmission, promotes dopamine release, and blocks acetylcholine. It is
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likely effective as monotherapy and adjunct therapy for off time and
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, dyskinesia. The Food and Drug Administration (FDA) has approved an
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extended-release version of amantadine (Gocovri), specifically for i,- i,- i,- i,- i,- i,- i,-


dyskinesias in PD, making it the only approved option for this complication
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Question:

Benztropine (Cogentin)? i,-




Answer:

Ach medications block acetylcholine and decrease the acetylcholine to
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dopamine concentration ratio. Ach minimizes resting tremor and drooling
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but are not as efficacious as other medications in treating rigidity,
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bradykinesia, and problems with gait i,- i,- i,- i,-




Question:

Dopamine agonists are the most effective medications for Parkinson's
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Disease.?
Answer:

F: Levodopa, a dopamine precursor, is the most effective medication for
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PD. Initiating pharmacotherapy for PD remains controversial. Patients
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experience approximately 50% improvement in motor function with
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levodopa compared to 30% with dopamine agonists.
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Question: