ANTIPARKINSONS Flashcards
Imbalance between which two neurotransmitters
Dopamine (inhibitory)
Acetylcholine (excitatory)
Parkinsons disease is
Chronic, progressive, neurodegenerative disorder affecting dopamine-producing neurons (These patients have a dopamine deficiency)
Parkinson’s disease symptoms
Bradykinesia
Postural instability
Rigidity
Tremors
Akinesia
Parkinsons Therapy issues
On-off phenomenon (some days you’ll have better symptom management than others)
Wearing off phenomenon (meds eventually develop tolerance and ware off)
Antiparkinsons
Benztropine (Cogentin)
Indirect-Acting dopamine receptor agonists: MAO-B inhibitor
Prevents breakdown of dopamine in peripheral tissues
-Causes an increase in levels of dopaminergic stimulation in the CNS
Only used in combination with Carbidopa-Levodopa
MAO-B adverse effects
Mild-postural hypotension may occur
Indirect-acting dopamine-receptor agonists: COMT inhibitors
Prevents breakdown of dopamine in peripheral tissues
Prolong the duration of action of levodopa; reduce wearing off phenomenon
COMT inhibitors adverse effects
GI upset
Body fluid discoloration (this doesn’t cause harm to patient)
Indirect-acting dopamine receptor agonists: Dopamine releaser
Used early on the course of the disease. Helps control dyskinesia (motor rigidity)
Usually effective for only 6 to 12 months and then a dopamine agonist is tried
Dopamine releaser adverse effects
Dizziness
Nausea
Confusion
Direct dopamine receptor agonists function
Stimulate production of more dopamine
Direct dopamine receptor agonists adverse effects
Dizziness
GI upset
Dopamine replacement drugs
Carbidopa-levodopa (sinemet)
Dopamine replacement drugs adverse effects
Hypotension
Urinary retention
Depression
Dyskinesia
Palpitations
Cardiac dysrhythmias
GI distress
Chorea
When should you take dopamine replacement drug?
On an empty stomach (This is because food delays absoprtion)
Anticholinergics
Benztropine mesylate (cogentin)
Anticholinergic therapy adverse effects
Drowsiness, confusion, disorientation
Constipation, nausea, vomiting
Urinary retention, pain on urination
Blurred vision, dilated pupils, photophobia, dry skin
Decreased salivation, dry mouth
Antiparkinsons drugs priority nursing implications
Start with low doses because of medication
On-off phenomenon
Wearing-off phenomenon
