Paper I
2019 July (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Levodopa and carbidopa combination in Parkinson’s disease

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Answer

Carbidopa is a peripheral dopa-decarboxylase inhibitor that does not cross the blood-brain barrier. It blocks peripheral conversion of levodopa to dopamine, increasing the fraction of administered levodopa that reaches the brain (allowing a lower levodopa dose to be used) while markedly reducing peripheral dopamine-mediated adverse effects (nausea, vomiting, hypotension, arrhythmias), which are otherwise common and dose-limiting when levodopa is given alone.

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