QuestionSBA
QuestionChoice
Co-careldopa could cause excessive daytime sleepiness and sudden onset of sleep. Hence, patients should be warned of the risk and need to exercise caution when driving or operating machinery
34100
a
Co-careldopa could lead to excessive daytime sleepiness
QuestionChoice
Patients are reminded to take co-careldopa at the same time each day to help control their symptoms
34103
d
He should take co-careldopa at different times of the day to decrease the risk of dizziness
QuestionChoice
Patients are usually started on low dose to reduce chances of side effects
34102
c
Maximum dose of careldopa is usually given at the start to ensure complete control of symptoms
QuestionChoice
Dose of co-careldopa needs to be reduced gradually before it can be stopped completely to prevent withdrawal symptoms such as stiff muscles, fever and altered mental status
34104
e
Co-careldopa can be stopped instantly once the symptoms have improved
QuestionChoice
Co-careldopa consists of both levodopa and carbidopa. Levodopa is converted into dopamine to help replenish the level of dopamine in substantia niagra. Carbidopa prevents the levodopa from being broken down into dopamine in parts of the body other than the brain. It does not decrease the risk of impulsive behaviour
34101
b
Carbidopa in the co-careldopa decreases the risk of impulsive behaviour associated with levodopa
QuestionComment
Bit uncertain about this answer. Looking in the BNF (03.02.2022) drowsiness and sleep disorders are deemed to be rare or very rare. The BNF also states that this drug is associated with impulse control disorders and that patients should be aware of this, but doesn't specify frequency.
6921
QuestionComment
There's a big bit on sudden onset of sleep in the 'Patient and Carer Advice" section on the BNF page. I got caught out by this before, so always check there as well as side effects now, can be a place where they talk about specific well-known side effects (even if they are uncommon).
18763
User
subscriber
DNA Haemophilus
User
subscriber
Jaundiced bizzle
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2764
Levodopa
Topic
74
Elderly Care
6831
Case presentation: A 75-year-old man attends the Parkinson clinic with a 3-month history of rigidity, slow movement and a left-sided resting tremor. He denies any hallucination, incontinence or diplopia. Idiopathic Parkinson’s disease is suspected and a dopaminergic agent trial with 25/100mg Co-careldopa (carbidopa/levodopa) is to be initiated.




Question: Select the most important information that should be provided for this patient.
a