NAPLEX Practice Question # 33

NAPLEX Examination.

Practice Question # 33.




Ropinirole (Requip) NAPLEX Review

Mechanism of action is similar to pramipexole.

Administration and dosage

  • Initial treatment: 0.25 mg three times daily
  • Titrate weekly increments
  • Aft er week 4, if necessary, daily dosage may be increased by 1.5 mg/day on a weekly basis up to 9 mg/day, to a total of 24 mg/day.
  • Discontinue gradually over a 7-day period. Decrease the frequency of administration from three times to two times daily for 4 days and then once daily for the remainder of the week.
  • When given in combination with levodopa, consider reduction of levodopa dose.
  • May be taken with food to reduce the occurrence of nausea. Food decreases the rate of absorption but not the extent of absorption.
  • Metabolized by the liver (cytochrome P450 1A2) and fi rst-pass eff ect
  • Smoking induces the liver metabolism.
  • Between 30% and 40% protein bound

Precautions and monitoring effects

  • Bradycardia is observed in patients treated with ropinirole. Most cases occur within the fi rst 4 weeks of therapy and are usually associated with a recent increase of dose.
  • Binds to melanin-containing tissues like the eyes and skin
  • Symptomatic hypotension
  • Dopaminergic agents appear to impair the systemic regulation of blood pressure,
  • which results in orthostatic hypotension.
  • Monitoring and education of the patient is necessary, especially during doseescalation periods.

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