antiparkinson drugs (3) Flashcards
parkinson’s disease is a progressive condition based on decreased ______ in the brain
dopamine
what is one of the main drugs used to replace dopamine
carbidopa-levodopa
(rapid swings in response to the medication can occur: on-off phenomenon)
describe the OFF (too little) swing in response to levodopa
- wearing-off phenomenon
- medication may lose effectiveness towards the end of each dose
- complementary drugs or an increased dose may be needed
____: difficulty with voluntary movements can occur during the ON (too much) phenomenon
dyskinesia
selegiline and rasagiline are examples what what type of drug
indirect-acting dopaminergic drugs: monoamine oxidase inhibitors (MAOIs)
- increase dopaminergic stimulation in the CNS
(these drugs are MAO-B inhibitors)
with doses higher than 10mg of MAOIs there is a “cheese effect”, what is this effect
ingesting tyramine (cheese, beer, red wine, some yogurts) can cause severe hypertension, headache, and “feeling ill”
dopamine modulators like amantadine increase amounts of available dopamine to decrease ______
dyskinesia
(only effective for 6-12 months)
catechol ortho-methyltransferase (COMT) inhibitors are taken to do what
(tolcapone, entacapone, opicapone)
limit “off” episodes; prolong duration of action of levodopa and reduce the wearing-off phenomenon
name an adverse effect of COMT inhibitors
liver failure
(urine discoloration is expected, take with food, can worsen dyskinesias)
name the two types of direct-acting dopamine receptor agonists
- nondopamine receptor agonists (NDDRAs)
- dopamine replacement drugs
name side/adverse effects of nondopamine receptor agonists (NDDRAs)
GI upset, dyskinesias, sleep disturbances
name a dopamine replacement drug
carbidopa-levodopa
what is levodopa converted into when it crosses the blood-brain barrier
dopamine
large doses of levodopa have systemic, ______ effects
cardiovascular
_______ is given with levodopa to prevent levodopa breakdown in blood vessels
carbidopa
name some adverse effects of carbidopa-levodopa therapy (sinemet)
confusion, involuntary movements, cardiac dysrhythmias
name the effects of anticholinergics
dry mouth or decreased salivation, urinary retention, decreased GI motility (constipation), dilated pupils (mydriasis)
-opposite effects of acetylcholine
(treat muscle tremors, rigidity associated with PD from excess Ach)
what are some ways to manage the symptoms of anticholinergics
chew gum, drink frequently, use candy, eye drops
why should one be cautious during hot weather or exercise while taking the anticholinergic benztropine
it may cause hyperthermia (decreased sweating)
what should one avoid while taking the anticholinergic benztropine
alcohol
name some adverse effects of the anticholinergic benztropine
confusion, disorientation, toxic psychosis
what should patients be taught not to do while taking antiparkinson drugs
discontinue them suddenly
what are some things that can be monitored for when reviewing response to drug therapy
increased ability to perform ADLs, concentrate, and think clearly
