A client is started on levodopa-carbidopa. Which medications when combined with this medication can cause increases in blood pressure? Select all that apply.

Rationale: A. Metoclopramide: This medication is a dopamine antagonist that can reduce the effectiveness of levodopa rather than increase blood pressure. It may worsen Parkinsonian symptoms by blocking dopamine receptors, but it is not typically associated with hypertensive reactions when combined with levodopa-carbidopa. B. Tolcapone: Tolcapone is a COMT inhibitor used adjunctively with levodopa to prolong its effect. It can enhance dopaminergic activity but is not known to significantly increase blood pressure; instead, it may contribute to adverse effects like dyskinesias or hypotension. C. MAO: Monoamine oxidase inhibitors, particularly non-selective MAO inhibitors, can interact with levodopa to cause excessive catecholamine accumulation. This can lead to severe hypertension or hypertensive crisis due to increased norepinephrine and dopamine levels. D. Fluoxetine: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) and does not typically cause hypertensive reactions with levodopa. While there is a risk of serotonin syndrome with certain drug combinations, it is not associated with significant increases in blood pressure.