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RR, aged 80 years has Parkinson's disease, which is treated with a combination therapy comprising 300 mg of levodopa and 75 mg of carbidopa in three divided doses. Each combination tablet contains 100 mg of levodopa and 25 mg of carbidopa. RR takes the tablets at various times during the day, sometimes with food and at other times on an empty stomach. He comments that the tablets often make him feel nauseated, which is sometimes helped by lying down for a couple of hours. RR also complains about experiencing difficulties in swallowing the tablets.
Questions
1. What are the mechanisms of action of levodopa and carbidopa?
2. Explain the benefits of combining levodopa and carbidopa in the treatment of Parkinson's disease.
3. What advice would you offer RR about when to take the combination therapy?
4. What adverse effects are associated with levodopa and carbidopa?
5. What type of formulation could RR use to assist his swallowing problem?
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