406 E2- Parkinson's Pharm Flashcards
what is the treatment goal of parkinson’s
help individuals maintain their motor function for as long as possible
when is treatment for parkinson’s started
if symptoms affect dominate hand or if symptoms interfere w/ work, ADLs, social or leisure function
dopaminergic drugs can either
increase the amount of dopamine or increase the stimulation of dopamine receptors
what do anticholinergic drugs do
block the effects of ACh
sinemet (combo of levodopa & carbidopa) : MOA
-levodopa: converts to dopamine in the brain and activates dopamine receptors
-carbidopa: blocks destruction of levodopa
what is the most effective drug for PD
sinemet
disadvantages to sinemet
-takes several months to see improvement
-does not work long term
-adverse effects
sinemet: “loss of effect”
-dose wears off so may need shorter dose intervals
-“on off” phenomenon: the abrupt loss of effect that can occur anytime during dosing interval
off periods increase overtime
what can reduce the effect of sinemet
-other drugs
-high protein meals
sinemet: adverse effects
-N/v
-Dyskinesias (abnormal movements)
-postural hypotension
-dysrhythmias
-psychosis (hallucinations, nightmares, paranoia)
-darken sweat & urine
-activate malignant melanoma
sinemet nursing considerations
-give low doses w/ food (not protein rich food)
-monitor cardiac function (esp if dose is being increases)
-tell pts to change positions slowly
-skin assessment before giving
sinemet interactions causing a decreased effect of levodopa
-vit B6 (pyridoxine)
-antipsychotics
-protein
sinemet interactions causes a increased effect of levodopa
-carbidopa
-anticholinergics
-MAO inhibitors (can cause toxicity)
sinemet: route
PO
duopa
carbidopa-levodopa infusion for G or J tube
-gel form suspension
-continuous (up to 16 hrs/d) infusion for continuous blood level
keeps a more consistent amount of the drug in the body
