7/29/2019 A Patient is Being Treated Effectively for Parkinson

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A patient is being treated effectively for Parkinson's disease with levodopa. Suddenly,all

therapeutic benefits of the levodopa are lost and the adverse effects also disappear. Which

one of the following facts obtained from a medication historywould most likely explainthis phenomenon?

(A) The patient has forgotten to take two doses of themedication.

(B) The patient began using an OTC multi-vitamin product.(C) Selegiline was added to the drug regimen for 1 week.

(D) Antacids were taken occasionally.

(E) The patient regularly consumed alcoholic beverages

Answer

B

ExplanationThe administration of pyridoxine,even in the small doses (5 mg or more) contained

in ordinary vitamin preparations,is equivalent to a reduction in dosage of levodopa.

Pyridoxine is believed to be a cofactor for the enzyme dopa decarboxylase, which is

responsible for the peripheral metabolism of levodopa. The decarboxylated metabolicProduct can not enter the brain,which is the Desired site of action.

Which of the following drugs would be most appropriate to use for the treatmen to use

un-complicated gonorrhea infection in a poorly compliant patient?

(A) ceftriaxone (Rocephin)(B) pipericillin (Pipracil)

(C) tetracycline (AchromycinV)

(D) clindamycin (Cleocin)(E) itraconazole (Sporanox)

AnswerA

Explanation

The drug of choice in treating most forms of gonorrheais ceftriaxone (Rocephin).The drug is generally given in a single 125-mg 1/M dose.In patients who can not tolerate

a beta-Iactam antimicrobial agent, cipro-floxacin (Cipro) 500mg P.O.once or ofloxacin

(Floxin) 400 mg P.O.once may be given instead.