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Kapil Sethi, MD, FRCP
Novel Methods for Drug Delivery in Parkinson Disease (24:20)
Cheryl Waters, MD, FRCP
Rotigotine – Patch Delivery of a Dopamine Agonist (19:20)
Chair and Faculty
Question-and-Answer/ Discussion Session (8:30)

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  1. You are discussing the possibility of using the rotigotine patch with a patient who has Parkinson disease (PD). What should you tell the patient?

    A. Rotigotine has been shown to be effective in monotherapy only.
    B. Rotigotine has been shown to be effective as an adjunct to levodopa only.
    C. The main adverse effect of rotigotine is application site reaction.
    D. A major adverse effect of rotigotine is psychosis.

  2. One of the first attempts to symptomatically treat PD patients was initiated by Jean Martin Charcot in the 1800s. Charcot used a belladonna compound to treat such patients. What PD symptom was he primarily trying to treat?

    A. Resting tremor
    B. Bradykinesia
    C. Cogwheel rigidity
    D. Salivary drooling

  3. You are discussing treatment options with a patient who has moderately severe PD. What characteristic of the rotigotine patch might you emphasize as a significant clinical advantage over those of other treatment options?

    A. Strong drug-drug interactions occur between rotigotine and levodopa.
    B. The rotigotine patch must be changed every 12 hours.
    C. The rotigotine patch remains efficacious for 3 months.
    D. The rotigotine 40- and 60-cm2 patches are both effective for wearing off.

  4. Would orally dissolving levodopa/carbidopa tablets (Parcopa) be a good therapeutic alternative for a hospitalized PD patient with paralytic ileus?

    A. Yes. Blood levels are higher compared to those of standard levodopa/carbidopa.
    B. Yes. The need for gastric absorption is bypassed.
    C. Yes, although the ability to swallow is still required.
    D. No.

  5. The rotigotine transdermal patch system reaches steady-state plasma concentrations in approximately 48 hours.

    A. True
    B. False

  6. A patient with PD has just had a gastric tube placed. Why would continuous infusion be the best way to administer a levodopa/carbidopa gastric tube formulation (Duodopa) in this situation?

    A. Long-term PD effects result from this treatment.
    B. The levodopa/carbidopa gastric tube formulation is one of the simplest PD treatment regimens.
    C. Drug blood levels are very stable with this treatment.
    D. All are correct.

  7. Which of the following statements is correct regarding the rotigotine/levodopa interaction study?

    A. It was a multicenter, randomized, double-blind study.
    B. Study subjects were patients with idiopathic PD.
    C. Neither drug had a significant pharmacological influence on the other.
    D. One hundred twenty-five subjects were studied.

  8. A patient with moderately severe PD is experiencing a diminishing response to standard oral medication. Would it be appropriate to wean this patient from oral therapy and institute monotherapy with subcutaneous apomorphine?

    A. Yes. Apomorphine is a good primary drug because of its long half-life.
    B. No. Subcutaneous administration is more complex than oral administration.
    C. No. Apomorphine is not typically effective in treating PD "off" periods.
    D. None are correct.

  9. Which of the following statements is incorrect regarding the early-stage PD study?

    A. The study was performed in Europe.
    B. Study subjects were aged 30 years or older.
    C. Subjects had a Mini-Mental State Examination (MMSE) score of at least 25.
    D. The rotigotine therapeutic benefit was sustained over 6 months.

  10. Which of the following statements is correct regarding the rotigotine transdermal system in the advanced-stage PD study?

    A. Study subjects were in the "off" state at least 4 hours per day.
    B. Study subjects were not adequately controlled on levodopa.
    C. Rotigotine was not well tolerated by this patient group.
    D. Increased "on" time was not seen.