Why is not Levodopa the right answer here?
USMLE Step 1 Community
154 followers
17 Feb 2024
Levodopa
👍
1
Question:
A 68-year-old man presents to his physician with symptoms of hallucinations and hand tremors. His wife reports that he often appears to be in a daze and confuses his surroundings and family members. Cerebral MRI reveals multiple punctate hyperintense lesions in the basal ganglia. Given this clinical picture, which of the following medications should the physician avoid to prevent exacerbation of the patient's condition?
Options:
A)Levodopa
B)Metoclopramide
C)Donepezil
D)L-dopa
E)Propranolol
Levodopa
👍
1
Question:
A 68-year-old man presents to his physician with symptoms of hallucinations and hand tremors. His wife reports that he often appears to be in a daze and confuses his surroundings and family members. Cerebral MRI reveals multiple punctate hyperintense lesions in the basal ganglia. Given this clinical picture, which of the following medications should the physician avoid to prevent exacerbation of the patient's condition?
Options:
A)Levodopa
B)Metoclopramide
C)Donepezil
D)L-dopa
E)Propranolol
This is not asking what is his treatment. It is simply asking you know two things.
1 can you identify the pathology and likely underlying diagnosis which is parkinsonism
2 the side effects of medication and the medication that will worsen these symptoms and ultimately should therefore be avoided in this case.
This is not asking what is his treatment. It is simply asking you know two things.
1 can you identify the pathology and likely underlying diagnosis which is parkinsonism
2 the side effects of medication and the medication that will worsen these symptoms and ultimately should therefore be avoided in this case.
So, I believe if we look at the clinical picture, the individual is suffering from an exacerbation of Parkinson's. Metoclopramide is on the list of drugs with "parkinson-like syndrome" as an adverse effect (just like antipsychotics and reserpine)- I found this on page 252 of FA22. While Levodopa could cause hallucinations, tremors, and confusion when given too much of it, I believe it is more prudent to avoid the metoclopramide-- levodopa when given with carbidopa tends to be more beneficial. Hope this helps!
So, I believe if we look at the clinical picture, the individual is suffering from an exacerbation of Parkinson's. Metoclopramide is on the list of drugs with "parkinson-like syndrome" as an adverse effect (just like antipsychotics and reserpine)- I found this on page 252 of FA22. While Levodopa could cause hallucinations, tremors, and confusion when given too much of it, I believe it is more prudent to avoid the metoclopramide-- levodopa when given with carbidopa tends to be more beneficial. Hope this helps!