Managing Medications for Hospital Patients With Parkinson Disease

Dorothy J. Moore; Bonnie M. Smith; Maria H. Cho


Am Nurs Journal. 2017;12(1) 

In This Article

Medications for PD

PD medications fall into five general categories.

  • Carbidopa-levodopa (L-dopa), the mainstay of PD medications, is a combination drug. L-dopa crosses the blood-brain barrier, where it's converted to dopamine. Carbidopa doesn't cross this barrier; instead, it helps block L-dopa breakdown before it enters the brain, making more L-dopa available for transport to the brain.

  • Dopamine agonists (such as apomorphine, ropinirole, and pramipexole) mimic the effects of dopamine.

  • Monoamine oxidase B inhibitors (such as selegiline) block an enzyme that breaks down Ldopa.

  • Catechol-o-methyltransferase inhibitors (such as entacapone and tolcapone) inhibit an enzyme that degrades dopamine, prolonging its effect and easing wearing-off symptoms.

  • Anticholinergics enhance the activity of acetylcholine, a neurotransmitter that regulates movement and memory. (See Drugs commonly prescribed for Parkinson disease .)

Some patients also may be prescribed miscellaneous drugs, such as:

  • droxidopa, a synthetic norephinephrine precursor that raises blood pressure

  • rivastigmine tartrate, which slows acetylcholine breakdown and may help treat mild to moderate dementia associated with PD.

Factors that affect medication choices and dosages include the patient's age and signs and symptoms. Be aware that nausea is a major side effect of many PD medications. It can be so troublesome that some patients decide not to take their medications.