CHAPTER 5 Nervous System^245
- Orthostatic hypotension due to lack of norepinephrine within the sympa-
thetic nervous system, affecting the cardiovascular system
INTERPRETING TEST RESULTS
- Cerebrospinal fluid levels may show low levels of dopamine.
TREATMENT
- Administer antiparkinsonian agents which are able to cross the blood-brain
barrier. These drugs absorb better on an empty stomach:- levodopa
- carbidopa-levodopa
- Administer dopamine receptor agonists to act directly on the dopamine
receptor sites:- pergolide
- bromocriptine
- pramipexole
- ropinirole
- Administer selegiline, a selective monoamine oxidase B inhibitor that slows
the breakdown of dopamine and allows lower doses of levodopa to be used
because it prolongs its effect. - Administer catechol O-methyltransferase (COMT) inhibitors which help block
the breakdown of levodopa:- entacapone
- tolcapone
- Administer acetylcholine blocking drugs to decrease tremor and rigidity in
patients:- biperiden
- benztropine mesylate
- procyclidine
- orphenadrine
- trihexyphenidyl
- Diet high in protein and calories.
- Soft food diet.
- Physical therapy.