A 68-year-old male exhibits an asymmetric 4-Hz resting pill-rolling tremor, cogwheel rigidity, and bradykinesia. What is the most effective pharmacologic therapy?
Answer and explanation
Correct answer: D. Levodopa combined with carbidopa
- Step 1: The cardinal features of Parkinson disease are asymmetric resting tremor, rigidity, bradykinesia, and postural instability resulting from loss of dopaminergic neurons in the substantia nigra.
- Step 2: Levodopa combined with carbidopa (a peripheral dopa decarboxylase inhibitor) remains the gold standard and most potent symptomatic pharmacologic therapy.
Answer
Levodopa combined with carbidopa.
Why not the others: Haloperidol is a potent dopamine receptor antagonist that causes drug-induced parkinsonism and would exacerbate symptoms. Interferon beta-1a is a disease-modifying therapy for relapsing-remitting multiple sclerosis. Riluzole is approved for amyotrophic lateral sclerosis, not Parkinson disease.
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