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Pharm Exam 2 > CH 20: degenerative diseases of CNS > Flashcards

CH 20: degenerative diseases of CNS Flashcards

1
Q

degenerative diseases are difficult to treat pharma bc

A

Medications are often unable to stop the progressive nature of these diseases, although they may be able to slow the disease and offer symptomatic relief.

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2
Q

Progressive loss of brain function characterized by memory loss, confusion, and dementia

A

Alzheimer’s disease

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3
Q

degenerative disease of the motor neurons characterized by weakness and atrophy of skeletal muscles; symptoms usually begin during middle age and progressively worsen

A

Amyotrophic lateral sclerosis (Lou Gehrig’s disease)

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4
Q

Demyelination of neurons in the CNS, resulting in progressive weakness, visual disturbances, mood alterations, and cognitive deficits

A

Multiple sclerosis

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5
Q

Progressive loss of dopamine in the CNS, causing tremor, muscle rigidity, and abnormal movements and posture

A

Parkinson’s disease

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6
Q

loss of neuronal function appears to be from

A

genetic and environmental factors

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7
Q

Symptoms of parkinsons develop because of

A

degeneration and destruction of dopamine-producing neurons found within an area of the brain

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8
Q

Balance, posture, muscle tone, and involuntary muscle movement depend on

A

the proper balance of the neurotransmitters dopamine (inhibitory) and acetylcholine (stimulatory) in the corpus striatum.

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9
Q

drug therapy for PD focuses not only on

A

restoring dopamine function but also on blocking the effect of acetylcholine within the corpus striatum.

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10
Q

Parkinson’s-like symptoms that occur as a result of therapy with antipsychotic drugs are called

A

extrapyramidal symptoms (EPS).

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11
Q

EPS may include acute

A

dystonias (muscle spasms)
akathisia (restless movement)
tar-dive dyskinesia (involuntary face and jaw movements).
fever
confusion

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12
Q

If acute EPS occurs in a healthcare facility, short-term medical treatment can be provided by administering parenteral

A

parenteral diphenhydramine (Benadryl).

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13
Q

Non-motor parkinson symptoms that significantly impair their quality of life.

A

*depression,
*anxiety,
*cognitive impairment
*sleep disorders

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14
Q

Antiparkinson drugs are given to

A

restore the balance of dopamine and acetylcholine in specific regions of the brain.

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15
Q

stimulate dopamine receptors

A

dopamine agonists

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16
Q

help to block enzymatic breakdown of dopamine within nerve terminals

A

MAO-B

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17
Q

rare, but life-threatening, idiosyncratic reaction to neuroleptic medications that is characterized by fever, muscular rigidity, altered mental status, and autonomic dysfunction.

A

Neuroleptic malignant syndrome (NMS)

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18
Q

cause of Neuroleptic malignant syndrome (NMS)

A

abrupt withdrawl of PD drugs

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19
Q

dopamine agonists

A

levodopa
carbidopa
entacpone

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20
Q

therapeutic effects of dopamine agonists

A

restores the neurotransmitter dopamine in extrapyramidal areas of the brain

21
Q

anticholinergic drugs

A

Benztropine
Diphenhydramine

22
Q

therapeutic effect of anticholinergics

A

Inhibit acetylcholine
allow dopamine to exert more influence

23
Q

MAO-B inhibitors help most with

A

tremors

24
Q

degenerative disorder characterized by progressive memory loss, confusion, and an inability to think or communicate effectively. Consciousness and perception are usually unaffected.

A

dementia

25
Q

AD is responsible for ___ of all dementia

A

70%

26
Q

known causes of dementia

A

multiple cerebral infarcts
severe infections
toxins.

Although the cause of most dementia is unknown, it is usually associated with cerebral atrophy or other structural changes within the brain.

27
Q

found within the brain at autopsy, are present in nearly all patients with AD.

A

Amyloid plaques and neurofibrillary tangles,

28
Q

Patients with AD experience a dramatic loss of ability to perform tasks that require ____as the neurotransmitter.

A

acetylcholine

29
Q

symptoms of AD

A

*Impaired memory and judgment
*Confusion or disorientation
*Inability to recognize family or friends
*Aggressive behavior
*Depression
*Psychoses, including paranoia and delusions
*Anxiety.

30
Q

most used class of drugs for treating AD

A

cholinerstase inhibitors

31
Q

The goal of pharmacotherapy in the treatment of AD is to improve function in three domains:

A

ADLs, behavior, and cognition.

32
Q

cholinerstase inhbitors therapeutic effects

A

When AChE is inhibited, acetylcholine levels become elevated and produce a more profound effect on the receptor.

33
Q

memantine therapeutic effect

A

reduces the abnormally high levels of glutamate.

34
Q

MS signs and symptoms

A

fatigue
heat sensitivity
neuropathic pain
spasticity
impaired cognitive ability
disruption of balance and coordination
bowel and bladder symptoms,
sexual dysfunction
dizziness
vertigo
visual impairment
slurred speech

35
Q

goal of drug therapy for MS

A

modifying the disease, treating acute episodes or relapses, and treating symptoms

36
Q

If drugs are not successful and the disease becomes gradually worse, as with progressive–relapsing MS:

A

immune-modulating drugs may provide benefit

37
Q

immune modulators ex

A

interferons

38
Q

immunosuppressants

A

mitoxantrone
Monoclonal antibodies
alemtuzumab

39
Q

monoclonal antibodies therapeutic effect

A

Your body naturally makes antibodies to fight infection. However, your body may not have antibodies designed to recognize a novel (or new) virus

40
Q

wearing off effect of PD drugs

A

may need drug holiday
drugs may lose effects

41
Q

MAO-B inhibitors MOA

A

inhibit breakdown of dopamine so it stays in the system

42
Q

what to look out for with immunosuppressants

A

urine output
infection control

43
Q

immunosuppressant adverse effects

A

Nausea
vomiting
fever
mouth sores
diarrhea
hair loss
anemia
increased susceptibility to infection
Cardiotoxicity
dysrhythmia
shortness of breath
myelosuppression

44
Q

drugs for treating PD

A

dopamine enhancing - anticholinergics

45
Q

nursing considerations for dopamine agonists

A

antihypertensives
anticonvulsants

46
Q

antidote for anticholinergics

A

physostigmine

47
Q

most used drug for AD

A

cholinerstase inhibitors

48
Q

adverse effects for cholinersterase inhibitors

A

Headache
dizziness
insomnia
nausea
diarrhea
vomiting
muscle cramps
anorexia
abdominal pain

49
Q

immune modulators therapeutic effects

A

decrease MS symptoms and number of lesions

Pharm Exam 2 (7 decks)

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