Psychiatric Drugs and Medications Q 31
Before administering amantadine (Symadine), the nurse should investigate which of the following client statements?
A. "My hands are always shaking."
B. "I had to take Dilantin 6 months ago."
C. "I take low-dose enteric aspirin each day."
D. "Simple tasks seem to take so long to perform."
Correct Answer: B. “I had to take Dilantin 6 months ago.”
Amantadine is used cautiously in clients with a history of seizures. When administering amantadine, renal monitor function, mental status, such as depression/suicidality and psychosis, and blood pressure. Those with seizure disorders have monitoring for seizure activity. Options A and D are clinical manifestations of Parkinson’s disease.
Option A: Amantadine is an antiviral agent with mild antiparkinsonian activity. In the treatment of Parkinson disease, studies have shown amantadine acts on dopamine neurons. Amantadine is a weak, non-competitive antagonist of the NMDA receptor, which increases dopamine release and prevents dopamine reuptake.
Option C: Amantadine does not interact negatively with aspirin. Amantadine is contraindicated in patients with hypersensitivity to the drug or components of the formulation. The drug undergoes renal excretion, so the extended-release dosage-form is contraindicated in patients with end-stage renal disease. Due to the possible anticholinergic side effects, patients with glaucoma or prostate hypertrophy should use it with caution.
Option D: Amantadine is now used mostly for Parkinson’s disease. Clinical trials have shown that amantadine decreases symptoms of bradykinesia, rigidity, and tremor. There is a combined synergistic effect with added levodopa, which is converted to dopamine by striatal enzymes in the CNS. There can be a transient benefit to the drug, so short-term therapy for patients with mild disease is best.