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NURS 251 (Pharmacology 1) > Antiparkinsonian Drugs > Flashcards

Antiparkinsonian Drugs Flashcards

1
Q

Parkinson’s is a chronic, progressive disorder that affects the __________ - producing neurons in the brain

A

Dopamine

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2
Q

Symptoms occur when around ___% of the dopamine stored is depleted

A

80

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3
Q

Classic symptoms include TRAP

A

Tremors, Rigidity (resistance to passive movement), Akinesia (inability to move muscles), Postural instability

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4
Q

What is on-off phenomenon regarding levodopa

A

On is when the med is working and symptoms are controlled. Off is when the medication is wearing off and symptoms worsen

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5
Q

What are the two common types of dyskinesia?

A

Chorea: involuntary movements of limbs and facial muscles. Dystonia: abnormal muscle tone leading to abnormal movements

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6
Q

What is the goal of drug therapy regarding Parkinsons

A

Slowing the progression of the symptoms rather than the disease

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7
Q

How do direct-acting dopamine receptor agonists work

A

Direct stimulation of presynaptic or postsynaptic dopamine receptors

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8
Q

Can bromocriptine work if the substantia nigra is damaged? Why?

A

No, because it activates presynaptic dopamine receptors to stimulate the production of dopamine. If it’s damaged there’s nothing to stimulate

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9
Q

As PD progresses, it becomes harder for levodopa to control it. How long does it take levodopa to become less effective

A

Generally 5 to 10 years after the start of the therapy.

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10
Q

What is a major contraindication of levodopa-carbidopa therapy? And when should be you be cautious?

A

Contraindication: Angle-closure glaucoma. Cautious: Open-angle glaucoma.

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11
Q

Monoamine Oxidase (MAO)

A

Breaks down catecholamines in the CNS, primarily in the brain

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12
Q

Anticholinergic Therapy (Parkinson’s)

A

Blocks the effects of ACh. It’s used to treat muscle tremors and rigidity which are caused by excessive cholinergic activity

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13
Q

What is SLUDGE and what is responsible for it?

A

Salivation, Lacrimation, Urination, Diarrhea, increased GI motility and Emesis(vomiting). ACh

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14
Q

What are initial signs and symptoms of PD

A

Masklike expression, speech problems, shuffling gait.

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15
Q

what are the adverse effects levodopa?

A

Confusion, Involuntary movements, Gi distress, hypotension, cardiac dysrhythmias

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16
Q

What drug interactions are there with levodopa?

A

pyridoxine, nonselective MAOIS, benzodiazepines, antipsychotics, dietary protein

17
Q

When is Carbidopa-levodopa (Sinemet) best taken?

A

On an empty stomach but it can be taken with food to minimize GI adverse effects

18
Q

How does Sinement CR affect the on-off phenomenon?

A

Increases on time and decreases off time

19
Q

What is the purpose of administering carbidopa alone?

A

Adjunct to treat nausea from carbidopa-levodopa (Sinemet) therapy

20
Q

What are 2 examples of MAO-B inhibitors and when are they used?

A

Selegiline HCL and rasagiline mesylate(Azilect). Use supplementary with levodopa.

21
Q

What do dopamine modulators do and name one

A

Release dopamine and other catecholamines from their storage sites in presynaptic fibres that haven’t been destroyed yet. Blocks reuptake of dopamine into nerve fibres resulting in higher dopamine levels in synapses and improved dopamine transmission in neurons. Amantadine HCL

22
Q

When can dopamine modulators be used and for how long

A

Used early in the course of the disease and usually only effective for 6 to 12 months

23
Q

What are adverse effects of amantadine?

A

Dizziness, insomnia, nausea

24
Q

Amantadine drug interactions?

A

Increased anticholinergic adverse effects when given with anticholinergic drugs

25
Q

What is the purpose of catechol ortho-methyltransferase (COMT) inhibitors and name one

A

Block COMT which is the enzyme that catalyzes the breakdown of the body’s catecholamines. They prolong the duration of the action of levodopa. Entacapone (Comtan)

26
Q

How does entacapone (comtan) affect the on-off phenomenon

A

Reduces off time

27
Q

What are adverse effects of COMT inhibitors

A

Upset GI, Urine discoloration, Can worsen dyskinesia that may already be present

28
Q

What effects do anticholinergic drugs have (opposite of SLUDGE)

A

Dry mouth, urinary retention, Constipation, Dilated pupils (mydriasis), and smooth muscle relaxation

29
Q

Name one anticholinergic drug

A

Benztropine mesylate

30
Q

What are adverse effects of Benztropine mesylate?

A

Tachycardia, confusion, disorientation, toxic psychosis, urinary retention, dry throat, constipation, nausea and vomiting

31
Q

Selegiline hydrochloride and rasagiline mesylate (Selective MAO-B inhibitors) Cause an increase in _____________

A

levels of dopaminergic stimulation in the CNS

NURS 251 (Pharmacology 1) (20 decks)

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