# A nurse is teaching a client newly started on levodopa-carbidopa about diet timing. Which client statement indicates the teaching has been effective?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391755&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A nurse is teaching a client newly started on levodopa-carbidopa about diet timing. Which client statement indicates the teaching has been effective?

## Option

1. "I will take my medication only with a high-fat snack."
2. "I will take my medication with a glass of milk to coat my stomach."
3. "I will take my medication 30 minutes before or 1 hour after meals high in protein." **✔ Correct answer**
4. "I will eat extra protein-rich foods to enhance the medication."

**Correct answer: 3**

## Explanation

Correct (2): Dietary protein (especially large neutral amino acids) competes with levodopa for absorption in the small intestine and transport across the blood-brain barrier, blunting drug effect. Best practice: take levodopa 30 minutes before or 1 hour after protein-rich meals. (1) Milk is protein-rich. (3) Extra protein decreases efficacy. (4) High-fat delays absorption without aiding it.

## In-depth explanation

Memory Tip Levodopa + Protein = Competition. Empty stomach is ideal but if nausea: take with a small low-protein snack (crackers). Caution AVOID vitamin B6 (pyridoxine) supplements unless co-administered with carbidopa — B6 accelerates peripheral levodopa breakdown.

## Clinical scenario

Scenario 64-year-old female, newly diagnosed Parkinson disease, starting levodopa-carbidopa 25/100 mg PO TID. Receiving outpatient diet teaching.

## Key concepts

- **Large neutral amino acid competition** — Dietary protein competes with levodopa absorption in gut and brain.
- **Levodopa-carbidopa** — Carbidopa inhibits peripheral decarboxylase, allowing more levodopa to cross the blood-brain barrier.
- **Pyridoxine interaction** — Vitamin B6 accelerates peripheral levodopa metabolism, reducing CNS effect; carbidopa minimizes this concern.

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