Dopaminergic Drugs
Levodopa, carbidopa, amantadine, bromocriptine, pergolide, pramipexole, ropinirole, selegiline, entacapone, and tolcapone increase dopamine concentrations in the brain and exert dopaminergic activity, directly or indirectly. Levodopa is the mainstay of drug therapy for idiopathic parkinsonism. Carbidopa is used only in conjunction with levodopa. The other drugs are used as adjunctive agents, usually with levodopa.
Levodopa, carbidopa, amantadine, bromocriptine, pergolide, pramipexole, ropinirole, selegiline, entacapone, and tolcapone increase dopamine concentrations in the brain and exert dopaminergic activity, directly or indirectly. Levodopa is the mainstay of drug therapy for idiopathic parkinsonism. Carbidopa is used only in conjunction with levodopa. The other drugs are used as adjunctive agents, usually with levodopa.
Levodopa (Larodopa, Dopar) is the most effective drug available for the treatment of Parkinson’s disease. It relieves all major symptoms, especially bradykinesia and rigidity. Although levodopadoes not alter the underlying disease process, it may improve a client’s quality of life.
Levodopa is contraindicated in clients with narrow-angle glaucoma, hemolytic anemia, severe angina pectoris, transient ischemic attacks, or a history of melanoma or undiagnosed skin disorders, and in clients taking MAO inhibitor drugs. In addition,levodopa must be used with caution in clients with severe cardiovascular, pulmonary, renal, hepatic, or endocrine disorders. Bromocriptine and pergolide are ergot derivatives and therefore are contraindicated in people hypersensitive to ergot alkaloids or those with uncontrolled hypertension. Selegiline, entacapone, and tolcapone are contraindicated in people with hypersensitivity reactions to the drugs. Tolcapone is contraindicated in people with impaired liver function.
