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MDC Final Exam Notes Study Guide 2025.
Parkland Formula a) 4ml x % BSA x weight (kg)= volume of fluid that needs to be infused b) ½ of the total volume of fluid in first 8 hours c) Last half in 16 hours MAP Calculation a) MAP= 1/3 * SBP + 2/3 * DBP Treatment for frostbite a) Rewarming the skin a. Rewarm the area using a warm-water bath for 15 to 30 minutes b. Skin may turn soft and look red or purple c. You may be encouraged to gently move the affected area as it rewarms. b) Oral pain medicine a. The rewarming process can be painful c) Protecting the injury a. Once the skin thaws, loosely wrap the area with sterile sheets, towels, or dressing to protect the skin. b. May have to protect fingers and toes as they thaw by gently separating them from each other c. You may need to elevate the affected area to reduce swelling d) Debridement (removal of damaged tissue) a. To heal properly, frostbitten skin needs to be free of damaged, dead or infected tissue. e) Whirlpool therapy or physical therapy a. Hydrotherapy can aid healing by keeping skin clean and naturally removing dead tissue b. Pt may be encouraged to move the affected area f) Antibiotics a. If the skin or blisters appear to be infected, the doctor may prescribe oral antibiotics g) TPA a. IV injection of a drug that helps restore blood flow (thrombolytic) such as TPA. b. TPA lowers the risk of amputation c. These drugs can cause serious bleeding and are typically used only in the most serious situations and within 24 hours of exposure. h) Wound care i) Surgery a. Severe frostbite patients may need surgery or amputation to remove dead or decaying tissue. j) Hyperbaric oxygen therapy a. Some patients show improved symptoms after this therapy, but more study is needed.
Treatment and differences of heat stroke and heat exhaustion a) Heat exhaustion a. Symptoms i. General weakness, increased heavy sweating, a weak but faster HR, N/V, possible fainting, pale/cold/clammy skin b. Treatment i. Stop physical activity, transfer to cool space ii. Cooling measures (ice water bath, mist skin with water, ice packs, special cooling blanket) iii. Rehydration therapy b) Heat stroke a. Symptoms i. Elevated body temperature above 103 F (39.4 C), rapid and strong HR, loss or change of consciousness, hot, red, dry, or moist skin b. Treatment i. Oxygen therapy, IV lines, urinary catheter, continuous cooling (Ice bath, mist skin with water, ice packs, special cooling blanket), benzodiazepine if shivering occurs, monitor for multi system organ dysfunction syndrome and electrolyte imbalances. Priority assessment in triage a) ABC’s Temperature reduction strategies a) Ice bath, mist skin with water, ice packs, special cooling blanket Skin injury related to frostbite a) Frostbite occurs in several stages: a. Frostnip i. Mild form of frostbite- does not permanently damage the skin ii. Continued exposure leads to numbness in the affected area iii. As the skin warms, the patient may feel pain and tingling. b. Superficial Frostbite i. Appears as reddened skin that turns white or pale ii. The skin may begin to feel warm- a sign of serious skin involvement iii. If you treat frostbite with rewarming at this stage, the surface of skin may appear mottled and you may notice stinging, burning, and swelling iv. Fluid-filled blisters may appear 12 to 36 hours after rewarming the skin c. Deep (Severe) Frostbite i. Skin turns white or bluish grey, and the patient may experience numbness, losing all sensation of cold, pain, or discomfort in the affected area. ii. Joints/muscles may no longer work
Addressing ventilator alarms a) Should never be turned off or ignored during mechanical ventilation b) The major alarms on the ventilator indicate either a high pressure or low exhaled volume c) If the alarm cannot be determined, ventilate the patient manually with a resuscitation bag until the problem is corrected by another health care professional Fractured ribs and flail chest a) Rib fracture a. Important info i. The most common cause is blunt trauma from a fall or car accident. Trauma can increase your risk for organ damage when your rib is fractured. ii. Older age, osteoporosis, or a tumor can increase your risk for rib fractures. iii. A stress fracture can happen in your upper or middle ribs. Stress fractures can happen when you have a forceful long-term cough. They can also be caused by forceful athletic movements, such as in golf, throwing, or rowing. iv. A condition called flail chest occurs if 3 or more of your ribs are broken in 2 or more places. This condition may make it hard for you to breathe. b. Signs and symptoms i. Chest wall pain that worsens when you breathe, move, or cough ii. Bruising or swelling near your injury iii. Shortness of breath or difficulty taking a deep breath c. Treatment i. Medications
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever.
- Prescription pain medicine may be given.
- Intercostal nerve block may be given to numb the injured area for about 6 hours. It is given as a shot between 2 of your ribs in the fractured area. You may need this if your pain continues or is getting worse even after you take oral pain medicines. ii. Surgery may be needed if your rib fracture is severe or several ribs are badly broken. Surgery is often needed for a flail chest. d. Management of symptoms i. Take deep breaths and cough 10 times each hour. This will decrease your risk for a lung infection. Hug a pillow on your injured side to decrease pain while you take deep breaths. Take a deep breath and hold it for as long as you can. Let the air out and then cough. Deep breaths help open your airway. You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece in your mouth and take a slow, deep breath, then let the air out and cough. Repeat these steps 10 times every hour. ii. Rest and limit activity as directed. Do not pull, push, or lift objects. Start to do more as your pain decreases. iii. Apply ice on your chest near your fractured rib for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag.
b) Flail chest Cover it with a towel. Ice helps prevent tissue damage and decreases swelling and pain. a. an injury that occurs typically following a blunt trauma to the chest. When three or more ribs in a row have multiple fractures within each rib, it can cause a part of your chest wall to become separated and out of sync from the rest of your chest wall. b. The chest moving unevenly between the separated part and rest of the chest is often the most definitive sign that you have a flail chest. The area of your chest that’s been traumatized will draw in when you breathe in, while the rest of your chest expands outward. When you breathe out, the affected area will expand out while the rest of your chest draws in. c. Treatment i. Your doctors will need to protect your lungs while ensuring that you can breathe adequately. They will give you an oxygen mask to assist your breathing and give you medication to help with your pain. ii. In more serious cases where there is associated underlying lung injury, you may need to be put on a mechanical ventilator in order to keep your chest cavity stable. It’s possible that surgery will be required, depending on the extent of injury and risks versus benefits of surgery. Chest injury a) Patients may be asymptomatic at first and can later develop various degrees of respiratory failure and possibly pneumonia b) These patients often have decreased breath sounds or crackles and wheezes over the affected area c) Other symptoms include bruising over the injury, dry cough, tachycardia, tachypnea, and dullness to percussion. d) At first the chest x ray may show no abnormalities but a hazy opacity in the lobes or parenchyma may develop over several days e) Management includes maintenance of ventilation and gas exchange Pneumothorax a) Collapsed lung b) Signs and symptoms a. sudden chest pain and shortness of breath. c) Causes a. Chest injury. i. Any blunt or penetrating injury to your chest can cause lung collapse. Some injuries may happen during physical assaults or car crashes, while others may inadvertently occur during medical procedures that involve the insertion of a needle into the chest. b. Lung disease. c. Ruptured air blisters.
b. Labored and unusually rapid breathing c. Low blood pressure d. Confusion and extreme tiredness c) Treatment a. Oxygen i. Supplemental oxygen. For milder symptoms or as a temporary measure, oxygen may be delivered through a mask that fits tightly over your nose and mouth. ii. Mechanical ventilation. Most people with ARDS will need the help of a machine to breathe. b. Fluids i. Carefully managing the amount of intravenous fluids is crucial. Too much fluid can increase fluid buildup in the lungs. Too little fluid can put a strain on your heart and other organs and lead to shock. c. Medication i. People with ARDS usually are given medication to:
- Prevent and treat infections, Relieve pain and discomfort, Prevent blood clots in the legs and lungs, Minimize gastric reflux, and Sedate d. pulmonary rehabilitation. i. Many medical centers now offer pulmonary rehabilitation programs, which incorporate exercise training, education and counseling to help you learn how to return to your normal activities and achieve your ideal weight. Pulmonary Embolism a) Overview a. a blockage in one of the pulmonary arteries in your lungs. In most cases, pulmonary embolism is caused by blood clots that travel to the lungs from deep veins in the legs or, rarely, from veins in other parts of the body (deep vein thrombosis). b) Symptoms a. Common signs and symptoms include: i. Shortness of breath. This symptom typically appears suddenly and always gets worse with exertion. ii. Chest pain. You may feel like you're having a heart attack. The pain is often sharp and felt when you breathe in deeply, often stopping you from being able to take a deep breath. It can also be felt when you cough, bend or stoop. iii. Cough. The cough may produce bloody or blood-streaked sputum. b. Other signs and symptoms that can occur with pulmonary embolism include: i. Rapid or irregular heartbeat, Lightheadedness or dizziness, Excessive sweating, Fever, Leg pain or swelling, or both, usually in the calf caused by a deep vein thrombosis, and Clammy or discolored skin (cyanosis) c) Prevention a. Blood thinners (anticoagulants).
i. These medications are often given to people at risk of clots before and after an operation — as well as to people admitted to the hospital with medical conditions, such as heart attack, stroke or complications of cancer. b. Compression stockings. i. Compression stockings steadily squeeze your legs, helping your veins and leg muscles move blood more efficiently. c. Leg elevation. i. Elevating your legs when possible and during the night also can be very effective. d. Physical activity. i. Moving as soon as possible after surgery can help prevent pulmonary embolism and hasten recovery overall. This is one of the main reasons your nurse may push you to get up, even on your day of surgery, and walk despite pain at the site of your surgical incision. e. Pneumatic compression. i. This treatment uses thigh-high or calf-high cuffs that automatically inflate with air and deflate every few minutes to massage and squeeze the veins in your legs and improve blood flow. d) Treatment a. Medications: i. Blood thinners (anticoagulants). These drugs prevent existing clots from enlarging and new clots from forming while your body works to break up the clots. Heparin is a frequently used anticoagulant that can be given through the vein or injected under the skin. It acts quickly and is often overlapped for several days with an oral anticoagulant, such as warfarin, until it becomes effective, which can take days. ii. Clot dissolvers (thrombolytics). While clots usually dissolve on their own, sometimes thrombolytics given through the vein can dissolve clots quickly. Because these clot-busting drugs can cause sudden and severe bleeding, they usually are reserved for life-threatening situations. b. Surgical and other procedures: i. Clot removal. If you have a very large, life-threatening clot in your lung, your doctor may suggest removing it via a thin, flexible tube (catheter) threaded through your blood vessels. ii. Vein filter. A catheter can also be used to position a filter in the body's main vein (inferior vena cava) that leads from your legs to the right side of your heart. This filter can help keep clots from going to your lungs. This procedure is typically reserved for people who can't take anticoagulant drugs or when they have had recurrent clots despite use of anticoagulants. Assessment of LOC
a) characterized by the temporary reduction or loss of reflexes following a spinal cord injury. b) Symptoms a. Altered body temperature b. Skin color and moisture changes (such as dry and pale skin) c. Abnormal perspiration function (decreased or increased sweating, flushing) d. Increased blood pressure and slowed heart rate e. Irregularities in the musculoskeletal system f. Altered sensory response g. Unusual urinary bladder and GI tract functions (overflow and incontinence) h. Irregular vasomotor response i. Depressed genital reflexes Seizure care a) Mark the seizure start time. b) If a patient is standing, lay them to the ground and roll them to the side. If the patient is in bed, roll them to the side c) The patient can never swallow their tongue. Never place anything in patient mouth or try to open their mouth. This can compromise the airway or cause more harm to the patient. d) Never hold the patient down or try to stop their movements. This can cause injury to the patient. Instead, protect the patient from hitting hard surfaces with soft puddings like pillows. e) By rolling the patient to the sides, you may achieve a patent airway. f) Administer 100% oxygen g) Check oxygen saturation. It may be below 90 due to apnea. The patient may turn blue on the lips and fingers. Do not panic! h) Patient will have oral secretions. Suction at bedside to keep the airway patent. i) If help is available, establish an IV- line for possible IV medication administration if the seizure continues for a long time (Status epilepticus). You do not have to have a physician order to start an IV line in this case. j) Put the side rails up to prevent falls k) Pad the bed of any patient expected to get seizures. Injuries caused by unpadded bed can count against you. l) Your drug of choice during seizure is Ativan IV push. Homonymous hemianopsia and how to deal with deficit a) a condition in which a person sees only one side -- right or left -- of the visual world of each eye and results from a problem in brain function rather than a disorder of the eyes themselves. b) Treatment a. Strategies to improve reading ability: i. Use a straight edge to direct the eyes to the next line of text. ii. Work on willingly increasing the size of small eye movements as words are read along the line of text. The goal is to capture each word in the field of vision and to recognize it as a whole before reading it.
iii. Place your hand at the edge of a page to make it easy to determine the margin of a page. iv. Hold the text at a 45- to 90-degree angle so that reading is done vertically rather than horizontally. People with a right hemianopsia should read down, while those with a left hemianopsia should read up. In each case, this will keep the next line of text within the available field of vision. b. Strategies to improve navigating the environment: i. When moving through the environment, learn to direct the eyes toward the good visual field. ii. When walking into a new environment, pause and move your head from one side to another. Observe where objects and people are located. Think about painting a picture of what you see in your brain. Practicing this, particularly in the 6 months after vision loss, can help train your brain to do this automatically. iii. When looking for objects in the blind field consciously make large eye movements to that side and then let the eyes come back to the object. iv. When walking, let a partner walk on the blind side and provide his or her arm for guidance. v. When in group situations, situate people in the good field of vision as much as possible. vi. When in a theater, sit far over to the blind side so that the action takes place in the normal visual field. vii. Play real-life (not computer-based) card games and do crossword puzzles to regain coordination between vision and touch. viii. Do word search or picture search puzzles to improve eye scanning at near distances. c. Other treatment i. Prisms on glasses may help to expand the area for central vision. A prism can displace images of objects into the field of vision. ii. Some makers of computer-assisted programs claim to promote recovery of the entire field of vision. However, there are no proven studies showing such programs are effective. In addition, they are very expensive. iii. Driving a motor vehicle is hazardous for many people with homonymous hemianopsia, particularly if other neurological problems are present. Practice on a driving simulator offers a chance to regain driving skills and allows an instructor to determine if the patient is able to drive again. Prevention of myasthenic and cholinergic crises a) Myasthenic crisis a. It is a complication of a condition known as myasthenia gravis, a chronic autoimmune disorder that is characterized by rapid fatigue and weakness of voluntarily controlled muscles. b. Symptoms
e. Monitor for constipation. f. Promote independence along with safety measures. g. Avoid rushing the client with activities. h. Assist with ambulation and provide assistive devices. i. Instruct client to rock back and forth to initiate movement. j. Instruct the client to wear low-heeled shoes. k. Encourage the client to lift feet when walking and avoid prolonged sitting. l. Provide a firm mattress, and position the client prone, without a pillow, to facilitate proper posture. m. Instruct in proper posture by teaching the client to hold the hands behind the back to keep the spine and neck erect. n. Promote physical therapy and rehabilitation. o. Administer anticholinergic medications as prescribed to treat tremors and rigidity and to inhibit the action of acetylcholine. p. Administer antiparkinsonian medications to increase the level of dopamine in the CNS. q. Instruct the client to avoid foods high in vitamin B6 because they block the effects of antiparkinsonian medications. r. Instruct the client to avoid monoamine oxidase inhibitors because they will precipitate hypertensive crisis. Management of Guillain-Barre syndrome a) an autoimmune disease in which there is an acute inflammation of the spinal and cranial nerves manifested by motor dysfunction that predominates over sensory dysfunction. b) Symptoms a. often begins with tingling and weakness starting in your feet and legs and spreading to your upper body and arms b. Prickling, pins and needles sensations in your fingers, toes, ankles, or wrists c. Weakness in your legs that spreads to your upper body d. Unsteady walking or inability to walk or climb stairs e. Difficulty with facial movements, including speaking, chewing, or swallowing f. Double vision or inability to move eyes g. Severe pain that may feel achy, shooting or cramp like and may be worse at night h. Difficulty with bladder control or bowel function i. Rapid heart rate j. Low or high blood pressure k. Difficulty breathing c) Treatment a. Plasma exchange (plasmapheresis) i. The liquid portion of part of your blood (plasma) is removed and separated from your blood cells. The blood cells are then put back into your body, which manufactures more plasma to make up for what was removed. Plasmapheresis may work by ridding plasma of certain antibodies that contribute to the immune system's attack on the peripheral nerves.
b. Immunoglobulin therapy i. Immunoglobulin containing healthy antibodies from blood donors is given through a vein (intravenously). High doses of immunoglobulin can block the damaging antibodies that may contribute to Guillain-Barre syndrome. c. medication to relieve pain, which can be severe and prevent blood clots, which can develop while you're immobile d) Therapy/PT a. Movement of your arms and legs by caregivers before recovery, to help keep your muscles flexible and strong b. Physical therapy during recovery to help you cope with fatigue and regain strength and proper movement c. Training with adaptive devices, such as a wheelchair or braces, to give you mobility and self-care skills e) Recovery a. After the first signs and symptoms, the condition tends to progressively worsen for about two weeks b. Symptoms reach a plateau within four weeks c. Recovery begins, usually lasting six to 12 months, though for some people it could take as long as three years Assessment signs for meningitis a) Signs and Symptoms a. Early symptoms will be similar to the flu, and they can develop over a matter of hours or even days. b. sudden high fever, stiff neck, severe headache, nausea or vomiting, confusion and difficulty concentrating, seizures, sleepiness or difficulty waking, sensitivity to light, no appetite or thirst, and skin rash b) Kernig’s sign a. To look for Kernig’s sign lie face up and flex your knee and hip in a 90˚ angle while someone else slowly extends your knee. i. If you feel either resistance or pain, see a doctor right away for treatment. c) Brudzinski sign a. To check for the Brudzinski sign, lie flat on your back. Your doctor will place one hand behind your head, and another on your chest to prevent you from rising. Then, your doctor will lift your head, bringing your chin to your chest. i. A positive Brudzinski sign occurs when this causes flexion of the hips. d) A third sign used to diagnose meningitis is called nuchal rigidity. Nuchal rigidity is an inability to flex the neck forward due to rigidity of the neck muscles. Post-operative breathing interventions a) cough and deep breathe every two to four hours. a. breathe deeply four times in a row and then coughing after the last deep breath in. b) incentive spirometer is a breathing toy used to exercise the lungs. a. Encourage to take slow, deep breaths when using the incentive spirometer.
b. High: dehydration, kidney or heart disease c) Platelet 150 , 000 -4 00 , 000 a. Low: viral infection, lupus, pernicious anemia (B12 deficiency), leukemia, chemo b. High: leukemia, bone marrow abnormalities, inflammatory conditions d) Creatinine 0 .8-1. 4 a. Low: low muscle mass, malnutrition b. High: low kidney function Understand the role of the Medical Reserve Corp a) a national network of volunteers, organized locally to improve the health and safety of their communities. b) MRC volunteers include medical and public health professionals, as well as other community members without healthcare backgrounds c) MRC units prepare for and respond to natural disasters, such as wildfires, hurricanes, tornados, blizzards, and floods, as well as other emergencies affecting public health, such as disease outbreaks. Understand the role of DMAT a) Disaster Medical Assistance Teams b) staffed with medical professionals and para-professionals who can help area health systems respond by providing expert patient care. c) members may be called on to help hospitals and healthcare facilities serve the needs of their patients, support medical sites and shelters, and more. Medication, use of Tagamet in burn injury a) pain medication, antibiotics, anti-anxiety medication, topical products for wound healing, such as bacitracin and silver sulfadiazine (Silvadene), and fluids for hydration b) tagamet increase cell immunity after injury Informed consent, know who can sign and who can sign if there is a change in capacity without an informed consent a) Doctor must explain the details of the procedure. The nurse can only clarify and watch the patient sign the informed consent after the doctor has spoke with the patient. Risk for those with latex allergies, who is at greatest risk? a) Risk factors a. People with spina bifida. The risk of latex allergy is highest in people with spina bifida — a birth defect that affects the development of the spine. People with this disorder often are exposed to latex products through early and frequent health care. b. People who undergo multiple surgeries or medical procedures. c. Health care workers. d. Rubber industry workers.
e. People with a personal or family history of allergies. You're at increased risk of latex allergy if you have other allergies — such as hay fever or a food allergy — or they're common in your family. b) Certain fruits contain the same allergens found in latex. They include: a. Avocado, Banana, Chestnut, Kiwi, Passion fruit Pt positioning in surgery a) Goals: a. Maintain the patient's airway and circulation throughout the procedure b. Prevent nerve damage c. Allow surgeon accessibility to the surgical site as well as for anesthetic administration d. Provide comfort and safety to the patient e. Prevent soft tissue or musculoskeletal and other patient injury b) Fowler’s position a. also known as sitting position, is typically used for neurosurgery and shoulder surgeries. The beach chair position is often used for nasal surgeries, abdominoplasty, and breast reduction surgeries. c) High-fowler’s a. the patient is usually seated (Fowler's position) at the head end of the operating table. The upper half of the patient's body is between 60 degrees and 90 degrees in relation to the lower half of their body. The legs of the patient may be straight or bent. d) Supine a. Laying with face up to the ceiling b. Supine position is commonly used for the following procedures: intracranial, cardiac, abdominal, endovascular, laparoscopic, lower extremity procedures, and ENT, neck and face. e) Jackknife a. also known as Kraske, is similar to Knee-Chest or Kneeling positions and is often used for colorectal surgeries. f) Kidney position a. resembles lateral position, except the patient's abdomen is placed over a lift in the operating table that bends the body to allow access to the retroperitoneal space. A kidney rest is placed under the patient at the location of the lift. g) Prone a. Lying face down b. often used for spine and neck surgeries, neurosurgery, colorectal surgeries, vascular surgeries, and tendon repairs. h) Lithotomy a. the patient can be placed in either a boot-style leg holder or stirrup-style position. b. This position is typically used for gynecology, colorectal, urology, perineal, or pelvis procedures. i) Sims
a. c) Complications: a. Thinking difficulties. i. You may experience cognitive problems (dementia) and thinking difficulties. These usually occur in the later stages of Parkinson's disease. Such cognitive problems aren't very responsive to medications. b. Depression and emotional changes. i. You may experience depression, sometimes in the very early stages. You may also experience other emotional changes, such as fear, anxiety or loss of motivation. Doctors may give you medications to treat these symptoms. c. Swallowing problems. i. You may develop difficulties with swallowing as your condition progresses. Saliva may accumulate in your mouth due to slowed swallowing, leading to drooling. d. Chewing and eating problems. i. Late-stage Parkinson's disease affects the muscles in your mouth, making chewing difficult. This can lead to choking and poor nutrition. e. Sleep problems and sleep disorders. i. People with Parkinson's disease often have sleep problems, including waking up frequently throughout the night, waking up early or falling asleep during the day. People may also experience rapid eye movement sleep behavior disorder, which involves acting out your dreams. Medications may help your sleep problems. f. Bladder problems. i. Parkinson's disease may cause bladder problems, including being unable to control urine or having difficulty urinating.
g. Constipation. i. Many people with Parkinson's disease develop constipation, mainly due to a slower digestive tract. h. Blood pressure changes. i. You may feel dizzy or lightheaded when you stand due to a sudden drop in blood pressure (orthostatic hypotension). i. Smell dysfunction. i. You may experience problems with your sense of smell. You may have difficulty identifying certain odors or the difference between odors. j. Fatigue. i. Many people with Parkinson's disease lose energy and experience fatigue, especially later in the day. k. Pain. l. Sexual dysfunction. i. Some people with Parkinson's disease notice a decrease in sexual desire or performance. d) Medications: a. Carbidopa-levodopa. Levodopa, the most effective Parkinson's disease medication, is a natural chemical that passes into your brain and is converted to dopamine. Levodopa is combined with carbidopa (Lodosyn), which protects levodopa from early conversion to dopamine outside your brain. This prevents or lessens side effects such as nausea. i. Side effects may include nausea or lightheadedness (orthostatic hypotension). ii. Also, you may experience involuntary movements (dyskinesia) after taking higher doses of levodopa. Your doctor may lessen your dose or adjust the times of your doses to control these effects. b. Inhaled carbidopa-levodopa. Inbrija is a new brand-name drug delivering carbidopa- levodopa in an inhaled form. It may be helpful in managing symptoms that arise when oral medications suddenly stop working during the day. c. Carbidopa-levodopa infusion. Duopa is a brand-name medication made up of carbidopa and levodopa. However, it's administered through a feeding tube that delivers the medication in a gel form directly to the small intestine. i. Duopa is for patients with more-advanced Parkinson's who still respond to carbidopa-levodopa, but who have a lot of fluctuations in their response. Because Duopa is continually infused, blood levels of the two drugs remain constant. d. Dopamine agonists. Unlike levodopa, dopamine agonists don't change into dopamine. Instead, they mimic dopamine effects in your brain. i. Dopamine agonists include pramipexole (Mirapex), ropinirole (Requip) and rotigotine (Neupro, given as a patch). Apomorphine (Apokyn) is a short- acting injectable dopamine agonist used for quick relief.
- Some of the side effects of dopamine agonists are similar to the side effects of carbidopa-levodopa. But they can also include
