entacapone

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entacapone

 [en-tak´ah-pōn]
an antidyskinetic agent used in conjunction with levodopa and carbidopa to enhance dopaminergic stimulation of the brain and the antiparkinsonian activity of levodopa in the treatment of idiopathic Parkinson's disease, administered orally.

entacapone

Comtan, Comtess (UK)

Pharmacologic class: Catechol O-methyltransferase (COMT) inhibitor

Therapeutic class: Antidyskinetic

Pregnancy risk category C

Action

Inhibits COMT, the primary enzyme involved in metabolizing levodopa. This inhibition increases levodopa blood level and duration of action, easing symptoms of Parkinson's disease.

Availability

Tablets: 200 mg

Indications and dosages

Adjunctive treatment of idiopathic Parkinson's disease in patients experiencing wearing off of carbidopa-levodopa effects

Adults: 200 mg P.O. with each carbidopa-levodopa dose, to a maximum of eight times daily (1,600 mg)

Contraindications

• Hypersensitivity to drug

Precautions

Use cautiously in:

• hepatic or renal dysfunction, hypertension, heart disease

• pregnant and breastfeeding patients.

Administration

• Give without regard to food.

• Administer at same time as carbidopa-levodopa. Make sure patient swallows tablet whole.

Don't withdraw drug abruptly.

Adverse reactions

CNS: dizziness, depression, drowsiness, disorientation, memory loss, agitation, delusions, hallucinations, paranoia, euphoria, dyskinesia, hyperkinesia, light-headedness, paresthesia, heaviness of limbs, numbness of fingers

CV: tachycardia, orthostatic hypotension, hypertension

GI: nausea, vomiting, epigastric pain, flatulence

GU: urine discoloration

Respiratory: upper respiratory tract infection, dyspnea, sinus congestion

Other: fever

Interactions

Drug-drug. Ampicillin, chloramphenicol, cholestyramine, erythromycin, probenecid, rifampin: decreased entacapone excretion

Bitolterol, dobutamine, dopamine, epinephrine, isoetherine, isoproterenol, methyldopa, norepinephrine: increased heart rate, increased risk of arrhythmias, excessive blood pressure changes

MAO inhibitors: increased risk of toxicity

Drug-behaviors. Alcohol use: increased risk of adverse reactions

Patient monitoring

• Monitor vital signs, watching especially for orthostatic hypotension.

• Evaluate neurologic status closely. Check for hallucinations and new onset or exacerbation of dyskinesia.

• Assess respiratory status, particularly for dyspnea and signs and symptoms of upper respiratory tract infection.

• Monitor nutritional and hydration status if patient experiences vomiting.

Patient teaching

• Instruct patient to swallow tablet whole and to take it at same time as carbidopa-levodopa.

Caution patient not to stop taking drug abruptly.

• Advise patient to move slowly when sitting up or standing, to avoid dizziness or light-headedness from sudden blood pressure decrease.

• Caution patient to avoid driving and other hazardous activities until drug no longer affects concentration and alertness.

Instruct patient (and caregiver) to institute safety measures at home to prevent injury related to disease or drug's adverse CNS effects.

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and behaviors mentioned above.

entacapone

A nitrocatechol-class COMT (catechol-O-methyltransferase) inhibitor used to improve motor performance in Parkinson patients receiving l-DOPA/carbidopa.

Adverse effects
Dyskinesia, which often resolves with ongoing therapy; diarrhoea, nausea and abdominal pain; asymptomatic red-brown urine.

entacapone

Comtan® Neurology A COMT inhibitor which may improve motor performance in Parkinson Pts receiving levodopa/carbidopa. See Parkinson's disease.
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2) Ballet de Minerve, commissioned by the queen mother, 19 March 1615, sixteen women dancers including the princesses Elizabeth and Christine, duchesses de Montpensier and Montmorency, comtesses de Soissons and La Rochefoucauld, marquises de Verneuil and Sable, Mme de Puysieux, and Mlles de Lomenie, Crescia, Verderonne, Neufvy, Vitry, and d'Urfe.
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Elle recoit dans sa chambre, a la mode ancienne, ses amis, dont les << vieilles comtesses >> qu'execrait Sophie Delaborde.