CH 20: degenerative diseases of CNS

Question 1

degenerative diseases are difficult to treat pharma bc

Answer 1

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.

Question 2

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

Answer 2

Alzheimer’s disease

Question 3

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

Answer 3

Amyotrophic lateral sclerosis (Lou Gehrig’s disease)

Question 4

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

Answer 4

Multiple sclerosis

Question 5

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

Answer 5

Parkinson’s disease

Question 6

loss of neuronal function appears to be from

Answer 6

genetic and environmental factors

Question 7

Symptoms of parkinsons develop because of

Answer 7

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

Question 8

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

Answer 8

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

Question 9

drug therapy for PD focuses not only on

Answer 9

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

Question 10

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

Answer 10

extrapyramidal symptoms (EPS).

Question 11

EPS may include acute

Answer 11

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

Question 12

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

Answer 12

parenteral diphenhydramine (Benadryl).

Question 13

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

Answer 13

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

Question 14

Antiparkinson drugs are given to

Answer 14

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

Question 15

stimulate dopamine receptors

Answer 15

dopamine agonists

Question 16

help to block enzymatic breakdown of dopamine within nerve terminals

Answer 16

MAO-B

Question 17

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

Answer 17

Neuroleptic malignant syndrome (NMS)

Question 18

cause of Neuroleptic malignant syndrome (NMS)

Answer 18

abrupt withdrawl of PD drugs

Question 19

dopamine agonists

Answer 19

levodopa
carbidopa
entacpone

Question 20

therapeutic effects of dopamine agonists

Answer 20

restores the neurotransmitter dopamine in extrapyramidal areas of the brain

Question 21

anticholinergic drugs

Answer 21

Benztropine
Diphenhydramine

Question 22

therapeutic effect of anticholinergics

Answer 22

Inhibit acetylcholine
allow dopamine to exert more influence

Question 23

MAO-B inhibitors help most with

Answer 23

tremors

Question 24

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

Answer 24

dementia

Question 25

AD is responsible for ___ of all dementia

Answer 25

70%

Question 26

known causes of dementia

Answer 26

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.

Question 27

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

Answer 27

Amyloid plaques and neurofibrillary tangles,

Question 28

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

Answer 28

acetylcholine

Question 29

symptoms of AD

Answer 29

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

Question 30

most used class of drugs for treating AD

Answer 30

cholinerstase inhibitors

Question 31

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

Answer 31

ADLs, behavior, and cognition.

Question 32

cholinerstase inhbitors therapeutic effects

Answer 32

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

Question 33

memantine therapeutic effect

Answer 33

reduces the abnormally high levels of glutamate.

Question 34

MS signs and symptoms

Answer 34

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

Question 35

goal of drug therapy for MS

Answer 35

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

Question 36

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

Answer 36

immune-modulating drugs may provide benefit

Question 37

immune modulators ex

Answer 37

interferons

Question 38

immunosuppressants

Answer 38

mitoxantrone Monoclonal antibodies alemtuzumab

Question 39

monoclonal antibodies therapeutic effect

Answer 39

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

Question 40

wearing off effect of PD drugs

Answer 40

may need drug holiday drugs may lose effects

Question 41

MAO-B inhibitors MOA

Answer 41

inhibit breakdown of dopamine so it stays in the system

Question 42

what to look out for with immunosuppressants

Answer 42

urine output infection control

Question 43

immunosuppressant adverse effects

Answer 43

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

Question 44

drugs for treating PD

Answer 44

dopamine enhancing - anticholinergics

Question 45

nursing considerations for dopamine agonists

Answer 45

antihypertensives anticonvulsants

Question 46

antidote for anticholinergics

Answer 46

physostigmine

Question 47

most used drug for AD

Answer 47

cholinerstase inhibitors

Question 48

adverse effects for cholinersterase inhibitors

Answer 48

Headache dizziness insomnia nausea diarrhea vomiting muscle cramps anorexia abdominal pain

Question 49

immune modulators therapeutic effects

Answer 49

decrease MS symptoms and number of lesions