Antiparkinson Drugs Flashcards
Carbidopa-Levodopa
Chemical Classification
Catecholamine
Carbidopa-Levodopa
Functional Classification
Antiparkinson agent
Carbidopa-Levodopa
Mechanism of Action
Decarboxylation of levodopa in periphery is inhibited by carbidopa; more levodopa is made available for transport to the brain and for conversion to dopamine in the brain
Carbidopa-Levodopa
Uses
Parkinson’s disease, parkinsonism resulting from carbon monoxide, chronic manganese intoxication, cerebral arteriosclerosis
Carbidopa-Levodopa
Contraindications
Hypersensitivity, malignant melanoma, history of malignant melanoma or undiagnosed skin lesions resembling melanoma
Carbidopa-Levodopa
Side Effects
CNS: Involuntary Choreiform Movements, Hand Tremors, Fatigue, Headache, Anxiety, Twitching, Numbness, Weakness, Confusion, Agitation, Insomnia, Nightmares, psychosis, hallucination, hypomania, severe depression, dizziness, impulsive behaviors, NEUROLEPTIC MALIGNANT SYNDROME
CV: Orthostatic Hypotension, tachycardia, hypertension, palpitation
EENT: blurred vision, diplopia, dilated pupils
GI: Nausea, Vomiting, Anorexia, Abdominal Distress, Dry Mouth, Flatulence, Dysphagia, bitter taste, diarrhea, constipation
HEMA: HEMOLYTIC ANEMIA, LEUKOPENIA, AGRANULOCYTOSIS
INTEG: rash, sweating, alopecia
MISC: urinary retention, incontinence, weight change, dark urine
Carbidopa-Levodopa
Nursing Considerations
ASSESS:
- PARKINSON’S SYMPTOMS: tremors, pill rolling, drooling, akinesia, rigidity, shuffling gait before, during treatment, BP, respiration; orthostatic BP
- Mental Status: affect, mood, behavioral changes, depression, complete suicide assessment
- Toxicity: muscle twitching, blepharospasm
- Renal, hepatic, hematopoietic tests; also for diabetes, acromegaly if on long-term therapy
Ropinirole (Requip)
Functional Classification
Antiparkinson agent
Ropinirole (Requip)
Chemical Classification
DOPamine-receptor agonist, nonergot
Ropinirole (Requip)
Mechanism of Action
Selective agonist for D2 receptors (presynaptic/postsynaptic sites); binding at D3 receptor contributes to antiparkinson effects
Ropinirole (Requip)
Uses
Parkinson’s disease, restless leg syndrome (RLS)
Ropinirole (Requip)
Contraindications
Hypersensitivity
Ropinirole (Requip)
Side Effects
CNS: Agitation, Insomnia, psychosis, hallucination, dystonia, depression, dizziness, somnolence, SLEEP ATTACKS, impulse control disorders
CV: Orthostatic Hypotension, tachycardia, hypo/hypertension, syncope, palpitations
EENT: blurred vision
GI: Nausea, Vomiting, Anorexia, Dry Mouth, constipation, dyspepsia, flatulence
GU: impotence, urinary frequency
HEMA: HEMOLYTIC ANEMIA, LEUKOPENIA, AGRANULOCYTOSIS
INTEG: rash, sweating
RESP: pharyngitis, rhinitis, sinusitis, bronchitis, dyspnea
Ropinirole (Requip)
Nursing Considerations
ASSESS:
- PARKINSONISM: akinesia, tremors, staggering gait, muscle rigidity, drooling
- BP, respirations during initial treatment; hypo/hypertension should be reported
- SLEEP ATTACKS: drowsiness, falling asleep without warning even during hazardous activities
- Mental status: affect, mood, behavioral changes, depression; complete suicide assessment; worsening of symptoms in restless leg syndrome
PERFORM/PROVIDE:
-Testing for diabetes mellitus, acromegaly if patient receiving long-term therapy
