And just like that, I wondered what Levodopa was for. Well I used to know what it was for and I thought that it's a significant drug which will show up in the board exam. I texted my classmate Alona, who was called by her classmates in her former section "Miss Pharma". It's an anti-Parkinson's drug, she texted back. I remember Paul who's in Canada now working as pharmacist. When he was still here, I mentioned levadopa and he said that levodopa is rarely used "as is" these days. Another drug is combined with it for some reason. Carba something. Carbidopa.

Levodopa
L-DOPA is used to replace dopamine lost in Parkinson's disease because dopamine itself cannot cross the blood-brain barrier where its precursor can. However, L-DOPA is converted to dopamine in the periphery as well as in the CNS, so it is administered with a peripheral DDC (dopamine decarboxylase) inhibitor such as carbidopa, without which 90% is metabolised in the gut wall, and with a COMT inhibitor if possible; this prevents about a 5% loss. The form given therapeutically is therefore a prodrug which avoids decarboxylation in the stomach and periphery, can cross the blood-brain barrier, and once in the brain is converted to the neurotransmitter dopamine by the enzyme aromatic-L-amino-acid decarboxylase. (source: Wikipedia)

Nursing Interventions for Levodopa

Assessment
History: Hypersensitivity to levodopa, tartrazine; glaucoma; history of melanoma; suspicious or undiagnosed skin lesions; severe CV or pulmonary disease; occlusive cerebrovascular disease; history of MI with residual arrhythmias; bronchial asthma; renal, hepatic, endocrine disease; history of peptic ulcer; psychiatric disorders; lactation, pregnancy
Physical: Weight; T; skin color, lesions; orientation, affect, reflexes, bilateral grip strength, vision exam; P, BP, orthostatic BP, auscultation; R, depth, adventitious sounds; bowel sounds, normal output, liver evaluation; voiding pattern, normal output, prostate palpation; liver and kidney function tests; CBC with differential

Implementation

• Arrange to decrease dosage if therapy is interrupted; observe for the development of suicidal tendencies.


• Give with meals if GI upset occurs.


• Ensure that patient voids before receiving dose if urinary retention is a problem.


• Monitor hepatic, renal, hematopoietic, and CV function.


• For patients who take multivitamins provide Larobec, a preparation without pyridoxine.

source: http://www.vandenberg.af.mil/~MDG/drugs/mg/levodopa.htm

Defense Mechanisms

After reading about Anna Freud's explanation on defense mechanisms, I started to think that almost everything that we do is a form of it.

A good example is me putting off doing the physical exam part of the group nursing process report. I admit I have been procrastinating. Instead of doing the school work, I play Starcraft on the computer instead. Procrastination is a sign of passive-agressiveness according to George Vaillant who wrote Adaptation to Life. He classifies it under Immature Mechanisms which is normal for individuals ages 3 to 15 years old.

These defense mechanisms have to be memorized for it will show up in the local board exam and NCLEX. Dang.

Dr. Cajucom said today that the midterm exam in Communicable Diseases would be very difficult. Now what is very difficult, I asked myself. Just when I got used to answering board exam type questions, the teacher began to explain the departamental exam. It's going to be full of definitions and identification. Dammit, that is so high school.

I'm supposed to be studying tonight but here I am playing Starcraft and watching Pinoy Big Brother.

A few days ago I stumbled across a really cool nursing blog Pinoy RN. There's this unsettling entry about a couple of House bills (2700 and 2926 holding back nurses from going to the United States right away. I so want to kill these representatives.

No classes tomorrow due to Labor Day here in the Philippines. That is good news because I'll have time to go to the gym and read my notes. Read my notes. Hah. That doesn't sound like me at all. I've been going through some NCLEX reviewers and I'm just shocked by how much stuff I have not retained mentally. My weakest points are Maternal and Child Nursing and Medical Surgical Nursing while my strong points (which isn't that strong, really) is probably Psychiatric Nursing and Fundamentals of Nursing.

Today I finally completed the enrollment process for my summer class in Manila Doctors College. I must say that the whole enrollment thingy was stress-free which was a pleasant surprise. Rhoda had this idea of paying the enrollment fee at Metrobank, the mother company of my school, to spare her from the trouble of lining up at the school cashier. I only have one subject this summer and it's called Enhancement something which is 4 days a week of duty plus lectures. Mrs Cervantes, the fourth year level coordinator, told us during the orientation that the topics to be covered will include psychiatric nursing. I forgot the other topic since I've been a scatterbrain lately.

Mrs Cervantes and Dr Ang were the members of my thesis proposal defense panel. They've managed to change the title which meant changing most part of the thesis. My groupmates and I have been stressed out because of the thesis proposal. I asked Mrs Cervantes before if I could work on my thesis alone but she said no. I prefer to work alone but then I thought that when I'm in the hospital, I'm going to have to learn teamwork so I might as well get a taste of nursing teamwork.

Last night, we were the last reporters of a slightly boring topics called nursing theories. It's about the different school of thoughts in nursing which nobody really cares about. It was almost 8pm and everyone was hungry and sleepy and I had to find a way for them to listen to me. The reporter before me was excruciating to listen to--she flashed the entire page of the report one at a time and read the whole report word by word. So I said to the class, "I have a question and whoever gets to answer first gets a prize. The prize is burger and fries from McDonald's." The class became wild--everyone wanted that burger. Then I took flashed the picture of Dorothy Johnson (a theorist) on the screen. My question was, "This is the picture of Dorothy Johnson who formulated the theory of the basic needs similar to Henderson's. My question is: who among your classmates looks like her?" Laughter. More laughter. And before anyone could say anything, I took out Johnson's picture and flashed the model of Johnson's theory.

Ms Tica grouped the class by 4's and assigned nursing behavioral system models for us to report. I so dislike reporting. I so detest working in groups.

Now that classes are over it feels like Christmas for me. Everyone doesn't seem to be in a hurry anymore.

Today we had our comprehensive exam in Healthcare. It was the most comprehensive exam I've taken in a long time. The exam seemed easy but you know how school exams are--sometimes they can look so easy but you end up getting a failing grade. The exam covered nursing skills from Healthcare 1 to 2. I tried to read chapters and chapters from the Potter and Perry book yesterday at Greenbelt but ended up watching Robots instead.

Submitted the requirements for getting my Parasitology and Microbiology subjects credited.

Looking forward to Nutrition and NCM this summer. :)