A client recently diagnosed with Parkinson's Disease is having education reinforced by the nurse. Which of the following medications would the nurse include in the client's education?
paroxetine (Paxil)
lisinopril (Prinivil)
risperidone (Risperdal)
levodopa (Inbrija)
The Correct Answer is D
A. Paroxetine is an SSRI antidepressant used for depression and anxiety disorders, not for Parkinson's Disease.
B. Lisinopril is an ACE inhibitor primarily used for hypertension and heart failure, and it does not address symptoms of Parkinson's Disease.
C. Risperidone is an atypical antipsychotic that may be used in some cases for behavioral symptoms but is not a primary treatment for Parkinson's Disease.
D. Levodopa (Inbrija) is a medication specifically indicated for the management of Parkinson's Disease, as it helps to replenish dopamine levels, alleviating motor symptoms associated with the disease.
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Correct Answer is D
Explanation
A. Diabetes Mellitus is not a contraindication for promethazine, although caution may be needed regarding metabolic control.
B. Chronic Kidney Disease does not specifically contraindicate the use of promethazine, but dosage adjustments may be necessary due to altered drug metabolism.
C. Iron Deficiency Anemia does not contraindicate the use of promethazine and would not raise significant concerns for its administration.
D. Narrow-Angle Glaucoma is a contraindication for promethazine due to its anticholinergic properties, which can increase intraocular pressure and worsen glaucoma.
Correct Answer is B
Explanation
A. A high first-pass effect means that a significant amount of the drug is metabolized by the liver before reaching systemic circulation, making oral administration less effective.
B. Morphine with a high first-pass effect will be more effective when administered via non-enteral routes, such as IV or subcutaneous, to bypass the liver's initial metabolism.
C. The first-pass effect does not influence the kidney’s rate of excretion but rather the liver’s initial metabolism of the drug.
D. The liver, not the kidneys, is responsible for the first-pass metabolism, which occurs before the drug reaches systemic circulation when taken orally.