| Drug and Dosage | Use | Action | Assessment: Side Effects |
|---|
| Benztropine (Cogentin)—PO 1–2 mg/day (range: 0.5–6 mg/day) | Parkinson’s disease | Blocks cholinergic activity in CNS | Blurred vision, dry eyes; constipation; caution with antihistamines, phenothiazines |
| NURSING IMPLICATIONS: Take as directed for best results; monitor for drowsiness, dizziness, orthostatic hypotension; good mouth care; use caution with OTC drugs, overheating (drug causes a decrease in perspiration) |
| Biperiden (Akineton)—PO 2 mg 3–4 times/day; not to exceed 16 mg/day | Parkinson’s disease | Restores natural balance of neurotransmitters in CNS | Same as Benztropine |
| NURSING IMPLICATIONS: See Benztropine |
| Carbidopa/levodopa (Sinemet)—PO (10/100, 25/100 carbidopa/levodopa ratio) 1 tablet 3 times/day up to 8 tablets daily | Parkinson’s disease | Levodopa is converted to dopamine in CNS, where it serves as a neurotransmitter | Use with MAO inhibitors may result in hypertensive crisis; some drugs can reverse effects (e.g., phenothiazines, reserpine) |
| NURSING IMPLICATIONS: Rate of dosage increase determined by client response; make accurate observations. May experience “on-off” phenomenon—loss of drug effects and sudden return. Prevent falling from postural hypotension, “leg freezing,” instability |
| Trihexyphenidyl (Artane)—PO 1–2 mg daily; usual maintenance dose: 5–15 mg/day in divided dose | Parkinson’s disease | Inhibits action of acetylcholine | Dizziness, nervousness, blurred vision, mydriasis |
| NURSING IMPLICATIONS: Monitor symptoms; avoid orthostatic hypotension; mouth care |