antiparkinson drugs (3)

Question 1

parkinson’s disease is a progressive condition based on decreased ______ in the brain

Answer 1

dopamine

Question 2

what is one of the main drugs used to replace dopamine

Answer 2

carbidopa-levodopa

(rapid swings in response to the medication can occur: on-off phenomenon)

Question 3

describe the OFF (too little) swing in response to levodopa

Answer 3

• wearing-off phenomenon
• medication may lose effectiveness towards the end of each dose
• complementary drugs or an increased dose may be needed

Question 4

____: difficulty with voluntary movements can occur during the ON (too much) phenomenon

Answer 4

dyskinesia

Question 5

selegiline and rasagiline are examples what what type of drug

Answer 5

indirect-acting dopaminergic drugs: monoamine oxidase inhibitors (MAOIs)

• increase dopaminergic stimulation in the CNS

(these drugs are MAO-B inhibitors)

Question 6

with doses higher than 10mg of MAOIs there is a “cheese effect”, what is this effect

Answer 6

ingesting tyramine (cheese, beer, red wine, some yogurts) can cause severe hypertension, headache, and “feeling ill”

Question 7

dopamine modulators like amantadine increase amounts of available dopamine to decrease ______

Answer 7

dyskinesia

(only effective for 6-12 months)

Question 8

catechol ortho-methyltransferase (COMT) inhibitors are taken to do what

(tolcapone, entacapone, opicapone)

Answer 8

limit “off” episodes; prolong duration of action of levodopa and reduce the wearing-off phenomenon

Question 9

name an adverse effect of COMT inhibitors

Answer 9

liver failure

(urine discoloration is expected, take with food, can worsen dyskinesias)

Question 10

name the two types of direct-acting dopamine receptor agonists

Answer 10

• nondopamine receptor agonists (NDDRAs)
• dopamine replacement drugs

Question 11

name side/adverse effects of nondopamine receptor agonists (NDDRAs)

Answer 11

GI upset, dyskinesias, sleep disturbances

Question 12

name a dopamine replacement drug

Answer 12

carbidopa-levodopa

Question 13

what is levodopa converted into when it crosses the blood-brain barrier

Answer 13

dopamine

Question 14

large doses of levodopa have systemic, ______ effects

Answer 14

cardiovascular

Question 15

_______ is given with levodopa to prevent levodopa breakdown in blood vessels

Answer 15

carbidopa

Question 16

name some adverse effects of carbidopa-levodopa therapy (sinemet)

Answer 16

confusion, involuntary movements, cardiac dysrhythmias

Question 17

name the effects of anticholinergics

Answer 17

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)

Question 18

what are some ways to manage the symptoms of anticholinergics

Answer 18

chew gum, drink frequently, use candy, eye drops

Question 19

why should one be cautious during hot weather or exercise while taking the anticholinergic benztropine

Answer 19

it may cause hyperthermia (decreased sweating)

Question 20

what should one avoid while taking the anticholinergic benztropine

Answer 20

alcohol

Question 21

name some adverse effects of the anticholinergic benztropine

Answer 21

confusion, disorientation, toxic psychosis

Question 22

what should patients be taught not to do while taking antiparkinson drugs

Answer 22

discontinue them suddenly

Question 23

what are some things that can be monitored for when reviewing response to drug therapy

Answer 23

increased ability to perform ADLs, concentrate, and think clearly