Dopar, Larodopa, L-dopa (levodopa)

Parcopa, Sinemet, Sinemet CR (carbidopa/levodopa)

Classification: antiparkinson agent, dopamine agonist

Indication (Use): Parkinson disease, not useful for drug induced extrapyramidal reactions

Normal dosage: Adult ~ Levodopa~ PO 250mg 2-4 times daily, may increase by 100- 750mg q
3-7 days until desired effect is achieved (not to exceed 8g/day)

Carbidopa/Levodopa~PO 10-25mg carbidopa and 100mg levodopa PO

t.i.d, increased by 1 tab daily or qod prn; max 8 tabs daily

Side Effects: CNS choreiform, dystonic, and dyskinetic movements, involuntary grimacing,
head movements, nervousness, anxiety, disturbing dreams, euphoria myoclonic body jerks,
ataxia, tremors, muscle twitching, bradykinetic episodes, memory loss, malaise, fatigue, severe
depression, suicidal tendencies, dementia, delirium, hallucinations CV: orthostatic hypotension,
cardiac irregularities, flushing, hypertension, EENT: blepharospasm, blurred vision, diplopia,
mydriasis or miosos, oculogyric crises, nasal discharge, excessive salivation GI: dry mouth,
bitter taste, N/V, anorexia, constipation, flatulence, diarrhea, epigastric pain. GU: urinary
frequency, urine retention, urinary incontinence, dark urine, excessive and inappropriate sexual
behavior, priapism. Hema: hemolytic anemia Hepatic: hepatotoxicity. Resp: hyperventilation,
hiccups Skin: dark perspiration

Nursing implications: Assess parkinsonian symptoms (akinesia, rigidity, tremors, pill rolling,
shuffled gain, mask-like-face, twisting motions and drooling)

Monitor: V/S, hepatic and renal functions and CBC periodically

Patient teaching: Explain the purpose of the medication, Thoroughly explain possible side
effects and what adverse reaction to look for. If a dose is missed take ASAP unless the next
scheduled dose is within 2hrs. What high protein diets because it may impair drug effects. This
drug may cause drowsiness so to use caution with all normal activities, Change positions slowly
to reduce the orthostatic possibilities, the importance of good oral hygiene. Making sure the pt.
understands the importance of contacting their physician’s office prior to taking any OTC cold
medicines.

Administration Principles: Admin food shortly after medication to minimize GI irritation. CR

tabs can be administered in whole or half tab but can NOT be crushed or chewed.