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Orally disintegrating tablet (ODT) technology is used in multiple pharmaceuticals.1 ODT carbidopa-levodopa (CD-LD) was introduced in 2004, and while this formulation is a more convenient dosing option for some patients, it still requires absorption in the proximal small intestine as does standard CD-LD. We report two patients with PD in whom ODT CD-LD was inappropriately used in the setting of paralytic ileus.
Case reports.
Case 1.
A 63-year-old woman with Parkinson disease (PD) for 8 years treated with standard CD-LD was admitted for cholecystectomy. Her postoperative course was complicated by paralytic ileus and encephalopathy, likely from sedative drugs. She was given ODT CD-LD during this period for her PD. We were consulted for worsening parkinsonism despite the patient taking an equivalent CD-LD preoperative dose in the form of ODT CD-LD. Our examination revealed global bradykinesia, marked cogwheel rigidity, and profound hypomimia. Once the ileus resolved, the patient resumed her preoperative dose of standard CD-LD and within 2 weeks she had returned to …
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