NAPLEX Question of the Week: Parkinson's Disease (Part 2)

Last week's question focused on drug-food interactions. This week's focuses on drug-drug interactions.

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GS is a 59 year-old female who recently was diagnosed with Parkinson’s disease. After consultation with her neurologist she agrees to begin treatment with oral selegiline in order to preserve carbidopa/levodopa therapy for a later time in her disease. After 3 months she has been titrated to 5mg twice daily. Which of the following medications may interact with her selegiline therapy if given together? Select all that apply.

A. Citalopram

B. Daptomycin

C. Linezolid

D. Tramadol

E. Vancomycin

Answers with rationale:

The correct answers are A, C, and D.

Citalopram due its selective serotonin reupkate inhibitor activity may increase the risk of serotonin toxicity. The longest risk with SSRIs would be with fluoxetine due to its prolonged half-life. Ensam, a transdermal MAO-inhitibitor, is not recommended to be given within at least 5 weeks of fluoxetine therapy.  Tramadol as well as linezolid are inhibitors of serotonin and norepinephrine reuptake and may potentially interact with selegiline. Daptomycin and vancomycin do not interact with selegiline.

Have a great week!

Dr. B

Christopher M. Bland

Clinical Professor, University of Georgia College of Pharmacy

Dr. Christopher M. Bland is a Clinical Professor at the University of Georgia College of Pharmacy at the Southeast GA campus in Savannah, GA. Dr. Bland has over 20 years of academic and clinical experience in a number of clinical areas. He is a Fellow of both the Infectious Diseases Society of America as well as the American College of Clinical Pharmacy. He is co-founder of the Southeastern Research Group Endeavor, SERGE-45, with over 80 practitioners across 14 states involved. Dr. Bland serves as Associate Editor for the NAPLEX Review Guide 4th edition as well as Editor-In-Chief for the Question of the Week. He has provided live, interactive reviews for more than 10 Colleges/Schools of Pharmacy over the course of his career.