Antiparkinson Drugs Chapter 15 Flashcards
benztropine mesylate** (Cogentin)
CLASS/ INDICATIONS
ANTIPARKINSON DRUGS: Chapter 15
CLASS: anticholinergics
INDICATIONS: adjunctive treatment of all forms of Parkinsons disease (tremor/ muscle rigidity), including drug-induced extrapyramidal effects and acute dystonic reactions
benztropine mesylate** (Cogentin)
DOSAGES
PO: 0.5-6 mg/day
benztropine mesylate** (Cogentin)
ADVERSE EFFECTS
tachycardia, confusion, memory impairment, rash, hyperthermia, constipation, dry throat/nose/mouth, nausea, vomiting, urinary retention, blurred vision, fever
benztropine mesylate** (Cogentin)
NURSING IMPLICATIONS/ CONTRAINDICATIONS
to be used with caution in hot weather or during exercise: may cause hyperthermia
benztropine mesylate** (Cogentin)
DRUG INTERACTIONS
anticholinergic syndrome (amantadine, phenothiazine, tricyclic antidepressants, alcohol)
carbidopa-levodopa** (Parcopa, Sinemet, Sinemet CR)
CLASS/ INDICATIONS
ANTIPARKINSON DRUGS: Chapter 15
CLASS: antiparkinson agents
INDICATIONS: usually started as soon as patient becomes functionally impaired, drug of choice for most elderly patients; adjunct to treat nasea associated with Sinamet
carbidopa-levodopa** (Parcopa, Sinemet, Sinemet CR)
DOSAGES
PO: 10/100, 1 tab 3-8 times/day
25/100, 1 tab 3-6 times/day
25/250, 1 tab tid-qid
carbidopa-levodopa** (Parcopa, Sinemet, Sinemet CR)
ADVERSE EFFECTS
palpitations, hypotension, urinary retention, depression, dyskinesia
carbidopa-levodopa** (Parcopa, Sinemet, Sinemet CR)
NURSING IMPLICATIONS/ CONTRAINDICATIONS
Must not be crushed/ can be split one time.
Possible interaction with dietary protein/ protein may interfere with uptake of levodopa.
carbidopa-levodopa** (Parcopa, Sinemet, Sinemet CR)
DRUG INTERACTIONS
additive toxicity, hypertensive reactions (nonselective MAOIs)
reduced levodopa effects, reduced therapeutic effects (benzodiazepines, antipsychotics)
ropinirole** (Requip, Requip XL)
CLASS/ INDICATIONS
ANTIPARKINSON DRUGS: Chapter 15
CLASS: direct-acting dopamine agonist, nonergot derivative
INDICATIONS: usually used as drug of choice for young patients; first or second line therapy of choice for elderly, can be used as adjunct to levodopa for off periods, can be used to reduce dyskinesia associated with later stages
ropinirole** (Requip, Requip XL)
DOSAGES
PO: 0.25 mg tid, slowly titrating to max dose of 24 mg/day
ropinirole** (Requip, Requip XL)
ADVERSE EFFECTS
edema, fatigue, syncope, dizziness, drowsiness, GI upset
ropinirole** (Requip, Requip XL)
DRUG INTERACTIONS
cytochrome P450 interactions; reduced ropinirole clearance with risk of toxicity (warfarin, ciprofloxacin)
