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69:252 Psychopharmacology > Antiparkinsonian Agents, Anticholinergic Agents > Flashcards

Antiparkinsonian Agents, Anticholinergic Agents Flashcards

1
Q

Increases the risk of psychosis
Effective in the urgent treatment of Neuroleptic malignant syndrome (NMS)

A

bromocriptine (Parlodel)

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2
Q

Used for: Dystonia, Parkinsonism, Akinesia, Akathisia

A

benztropine (Cogentin)

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3
Q

Cogentin
1-2 mg BID
PO/IM/IV

A

benztropine

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4
Q

__________ is responsible for:
S - salivation
L – lacrimation (tearing of the eyes)
U - urination
D - diarrhea
G – gastrointestinal motility
E - emesis

A

Acetylcholine

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5
Q

is a chronic progressive, degenerative disorder of the CNS
Symptoms:
resting tremor
bradykinesia
rigidity
postural instability
Risk Factors:
Age
Genetics
Sex
Exposure to Toxins

A

Parkinsons disease

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6
Q

Part of the Extrapyramidal Nervous System
Controls motor movement

A

Nigrostriatal pathway

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7
Q

Dopamine in Nigrostriatal pathway:
Decrease in Dopamine
Results in: __________

A

Parkinson Disease and EPS

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8
Q

Dopamine in Nigrostriatal pathway:
Chronic Blockage of D2 Receptors
Results in: __________

A

Hyperkinetic Movement Disorder (Tardive Dyskinesia)

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9
Q

______ of d2 receptors or ____ dopamine levels – difficulty controlling voluntary and involuntary muscle movement

A

Loss; low

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10
Q

___________ nervous system nerve fibres that are responsible brainstem to motor fibres of spinal cord (unconscious, reflexive or responsive control of musculature – muscle tone, balance, posture, locomotion)

A

Extrapyramidal

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11
Q

There is a reciprocal relationship between __________ and _________

A

Dopamine; Acetylcholine

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12
Q

Normal Functioning = Dopamine controls ____________ release

A

acetylcholine

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13
Q

widening the blood vessels in the cardiovascular system allowing blood to flow more easily.

A

Vasodilator

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14
Q

Blocking Dopamine (=decrease d2) causes an increase in ______
Increasing d2=decrease in Ach

A

ACh

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15
Q

_____ – receptor sites found in NIGROSTRIATAL pathways, dicephalon, medulla
Also found in peripheral nervous system – (rest and digest – parasympathetic)

A

CNS

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16
Q

________ receptor sites – found in parasympathetic nervous system

A

Cholinergic

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17
Q

Increase in acetylcholine activity = increase in ___________ side effects (nigrostriatal pathway)

A

extrapyramidal

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18
Q

_________ acetylcholine activity by reducing Dopamine increases the risk of EPS

A

Increasing

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19
Q

_____ potency antipsychotics have a high risk of EPS because of potency of dopamine blocking – hence increase in acetylcholine release – lower risk of anticholinergic effects

A

High

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20
Q

______ potency antipsychotics have a lower risk of EPS because potency of dopamine blocking is not as high and therefore not as much acetylcholine is released - but a much higher risk of _________ effects

A

Low; anticholinergic

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21
Q

Increase dopamine activity in the brain
E.g. bromocriptine (Parlodel)

A

Dopamine Receptor Agonists

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22
Q

Prevent the breakdown of brain dopamine by inhibiting the brain enzyme monoamine oxidase B

A

MAO-B Inhibitors

23
Q

Inhibit the action of acetylcholine in the brain and affect the parasympathetic nervous system.
E.g. benztropine (Cogentin)

A

Anticholinergic Drugs

24
Q

Both compete or inhibit histamine from binding at receptors
Anticholinergic antagonist (works on those receptors as well)

A

Antihistaminergic

25
Q

Competes to bind at adrenergic receptors and has an antagonist effect on certain serotonin receptors
Also used to reduce symptoms of Tardive Dyskinesia
E.g. Propranolol (Inderal)

A

ß Blocker

26
Q

Antiparkinsonian drugs: Absorption
well absorbed in the _____

A

GI Tract

27
Q

Antiparkinsonian drugs: Distribution
_______ distributed throughout the body

A

widely

28
Q

Antiparkinsonian drugs: Metabolism
______

A

liver

29
Q

Antiparkinsonian drugs: Excretion
______ & _______
cross the placenta and enter the breast milk

A

urine and bile

30
Q

Antiparkinsonian drugs _____ EPS but they can cause their own side effects

A

reduce

31
Q

Prophylactic prescription of antiparkinsonian drugs often occurs (________ PRN orders when antipsychotics are first prescribed)

A

Benztropine

32
Q

Rating scales (____) should be used to monitor clients side effects while on antipsychotic medication

A

AIMS

33
Q

Antipsychotics may cause emergency medical situations. These emergency medical situations will require immediate response and treatment.

A

Acute Emergency

34
Q

__________ (Oculogyric crisis, torticollis, opisthotonos)
Tx: Benztropine or Diphenhydramine (PO/IM/IV)

A

Dystonic Reactions

35
Q

____________
Tx: Immediate discontinuation of antipsychotic
Bromocriptine (PO)

A

Neuroleptic Malignant Syndrome

36
Q

Diphenhydramine (______) is often confused with dimenhydrinate (_______).

A

Benadryl; Gravol

37
Q

____________ Parkinson’s Drugs side effects:
Dry Mouth
Blurred Vision
Constipation
Stomach Irritation (nausea, vomiting)
Tachycardia
Urinary Retention, Hesitancy
Paralytic Ileus

A

Autonomic

38
Q

____________ Parkinson’s Drugs side effects:
Confusion
Giddiness
Listlessness
Depression
Visual Hallucinations
(EMERGENCY)

A

Behavioral

39
Q

Congestive Heart Failure, Decreased libido & Raynaud’s Syndrome
arrythmias

A

Propranolol

40
Q

________ also causes sedation

A

Diphenhydramine

41
Q

Orthostatic Hypotension, Livido Reticularis (vascular condition that causes purple mottling to the skin) & Abnormal Dreams

A

Amantadine

42
Q

_______ causes fewer anticholinergic effects but may cause euphoria and increased tremor

A

Biperiden

43
Q

______ Withdrawal Symptoms:
Nausea, vomiting
Dyskinesia
Restlessness
Sweating
Anxiety
Depression
Diarrhea
Dysphoria

A

Anticholinergic

44
Q

Anticholinergics need to be titrate down over ______ or _______. Clients who are being titrated down need to be constantly assessed for EPS

A

weeks; months

45
Q

impairment of voluntary movements

A

Dyskinesia

46
Q

state of unease or general dissatisfaction with life

A

Dysphoria

47
Q

There is a risk for anticholinergic agents to be misused.
Some clients find the effects on mood, memory and perceptions pleasurable.
Clients can feel greater sociability or euphoria on higher than normal doses.
This can also cause toxicity (either by purposeful misuse or by the client being prescribed to many drugs with an anticholinergic effect).

A

Anticholinergic Crisis

48
Q

“Hot as a hare, blind as a bat, mad as a hatter, dry as a bone”

A

Anticholinergic Crisis

49
Q

Dilated pupils
Increased thirst
Urinary retention
Paralytic ileus
Unsteady gait
Dry flushed skin
Tachycardia
Constipation
Decreased appetite and intake

A

Anticholinergic Crisis

50
Q

___________ Inhibitors – Donepezil (Aricept), Galantamine, and Rivastigime
- used to slow the symptom progression of Alzheimer’s – combination will produce an antagonistic action

A

Cholinesterase

51
Q

Other ___________ –
may cause additive anticholinergic effects and enhance adverse/toxic reactions

A

Anticholinergics

52
Q

_____________ ex Chlorpromazine
When used with anticholinergic agents there is a risk of potentially fatal paralytic ileus and an increased risk of toxic psychoses.

A

Phenothiazines

53
Q

Drug of choice for children over the age of 6 and more that 9 kg

A

diphenhydramine

54
Q
A

69:252 Psychopharmacology (14 decks)

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