Test Questions

Strategies for Enhancing Adherence in the Management of Parkinson’s Disease

Exam Questions

1. Which cardinal symptom of PD is experienced by close to 100% of patients?
    A. Postural instability
    B. Rest Tremor
    C. Bradykinesia
    D. Rigidity
2. Parkinson's patients:
    A. When newly diagnosed often need to be on multiple drug therapies to control their symptoms.
    B. Often can delay initiation of therapy three to five years after their initial diagnosis.
    C. Quickly learn that their clinical response is critically associated and closely tied to their level of medication adherence
    D. Can use most of their PD therapies as needed
3. When medication nonadherence does occur, which factor may be present in the patient with PD?
    A. Rigidity and tremor
    B. Depression, anxiety
    C. Side effects
    D. All of the above
4. Symptoms that are most likely to respond to carbidopa/levodopa therapy include:
    A. Rigidity and tremor
    B. Bradykinesia and constipation
    C. Fatigue and seborrhea
    D. Bradykinesia and dyskinesia
5. Which of the following is a therapy approved to be used initially upon diagnosis of PD?
    A. The MAO-B inhibitor rasagiline
    B. Carbidopa/levodopa
    C. A dopamine agonist such as pramipexole and ropinirole
    D. All of the above
6. Pharmacokinetics of PD therapies can influence prescribing habits. Which of the following statements is true?
    A. Carbidopa/levodopa has a long half-life and is available as a once-daily dosage form.
    B. Rasagiline is metabolized to dopamine in the brain.
    C. Selegiline is metabolized to L-amphetamine and L-methamphetamine.
    D. Pramipexole and ropinirole are available as a once-daily transdermal patch.
7. Patients with PD who experience nausea often can be safely treated with:
    A. Carbidopa or domperidone
    B. Carbidopa or haloperidol
    C. Domeperidone or metoclopramide
    D. Answers a and c are correct.
8. An add-on strategy to treat “wearing off” that arises with carbidopa/levodopa therapy is:
    A. Dopamine agonist therapy
    B. MAO-B inhibitor therapy
    C. Entacapone therapy
    D. All of the above
9. Which of the following statements is true regarding absolute contraindications associated with PD therapies?
    A. MAO-B inhibitors, dopamine agonists, and entacapone cannot be co-administered with nonselective MAOIs such as isocarboxazid, phenelzine, or tranylcypromine.
    B. Carbidopa/levodopa therapy is contraindicated in patients with a history of melanoma.
    C. There are no absolute contraindications for the rotigotine transdermal system.
    D. All of the PD therapies carry at least one black box warning.
10. Which one of the following therapies correlates correctly with its “warning?”
    A. Carbidopa/levodopa and the development of dyskinesia
    B. Dopamine agonists and sleep attacks
    C. MAO-B inhibitors and the co-administration of antidepressants
    D. All of the above
11. The average lifespan of a patient with PD is currently ___ years.
    A. 7
    B. 12
    C. 17
    D. 23
12. When initiating PD pharmacotherapy, it is important to consider:
    A. The age of the patient
    B. Comorbidities of the patient
    C. Lifespan of the patient
    D. All of the above
13. In a systematic review of adherence in relationship to dosing schedule, Claxton and colleagues demonstrated an average adherence rate of ___% for patients on a once-daily drug versus ___% for a QID drug.
    A. 50, 50
    B. 79, 51
    C. 51, 79
    D. 100, 80
14. Improved medication adherence with PD therapies may be realized with:
    A. Using liquid formulations for all patients
    B. Using TDS therapies for all patients
    C. Conducting one-on-one educational interventions
    D. All of the above
15. A review of multiple clinical trials involving PD therapies indicates that discontinuation rates with the active drug were as high as ___%, whereas discontinuation rates with placebo ranged from zero to 14.
    A. 13
    B. 17
    C. 23
    D. 27
16. In the data published by Leopold and colleagues, what was a common reason for missing a dose of PD therapy?
    A. Too busy/forgot
    B. Drug side effects
    C. Difficulty swallowing pill
    D. All of the above
17. Which of the following is a strategy to improve patients' adherence with PD medications?
    A. Providing a medication calendar
    B. Making recommendations to minimize pill-burden when appropriate
    C. Providing easy-to-open medication containers when appropriate
    D. All of the above
18. Which it true regarding carbidopa/levodopa therapy?
    A. It is an excellent first-line therapy for young patients with PD.
    B. It is associated with a high rate of dyskinesia that can be avoided with the co-administration of entacapone.
    C. The CR formulation cannot be crushed but can be halved.
    D. There is an orally dissolving formulation of carbidopa/levodopa /entacapone.
19. When counseling on the use of dopamine agonists, it is important to discuss which of the following?
    A. Taking with food may improve tolerability of the oral formulation.
    B. Most patients can remain at their initial starting dose for months to years.
    C. A common side effect with the transdermal system is skin irritation.
    D. Answers a and c are correct.
20. Counseling points for patients on MAO-B inhibitors should include which of the following?
    A. Patients should not exceed the maximum dosing recommendations/limits.
    B. Selegiline is neuroprotective and, therefore, will prevent the progression of the disease.
    C. For patients on carbidopa/levodopa therapy, rasagiline may have been prescribed to prevent “wearing off.”
    D. Answers a and c are correct.

Evaluation Questions

21. In questions 21-26, please rate the effectiveness of how well the activity met the stated learning objectives: Met objective 1:*
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
22. Met objective 2:*
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
23. Met objective 3:*
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
24. Met objective 4:*
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
25. Met objective 5:*
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
26. Met objective 6:
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
27. Related to your practice needs:
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
28. Will help you improve patient care:
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
29. Avoided commercial bias:
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
30. How would you rate the overall quality of the material presented?
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
31. How would you rate the overall user friendliness of the program?
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
32. Comments on this program:
 
* Also applies to pharmacy technicians