Chapter 20 Flashcards
How is Alzheimer’s diagnosed
PET scan
Parkinson’s Disease ANS symptoms
decreased tears, sexual function, orthostatic hypotension, cardiac dysrhythmias, constipation incontinence, heat intolerance
Anticholinergics use
parkinson’s-early stage
Anticholinergics function
Blocks acetylcholine
Inhibits overactivity in brain
Triexyphenidyl hydrochloride (Artane) and Benztropine mesylate (Cogentin) category
Anticholinergics
Dopaminergics
ex: levodopa #1 tx
Dopaminergics contraindications
narrow-angle glaucoma & undiagnosed skin lesions
Dopaminergics teaching
Increase fiber and fluids
Avoid food and drugs high in pyridoxine (B6) (breads)
May take several months for full effect
Abruptly stopping the drug may cause Parkinsonism crisis
Dopaminergic use
inhibit enzymes that destroy levodopa or directly activate dopamine receptor in the brain
Dopaminergic adverse effects
nausea/vomiting, dyskinesias, postural hypotension, psychosis, dark urine and sweat, activation of malignant melanoma
Dopaminergic Adjunct Agents cautions
Liver function impairment
increases K+ and BUN
Dopaminergic Adjunct Agents adverse effects
convulsions, shock
Dopaminergic Adjunct Agents examples
Bromocriptine (Parlodel)
Ropinirole (Requip)
Pramipexole (Mirapex)
Pergolide (Permax)
MAO-B inhibitors use
parkinson’s
Enhance effects of L-dopa
not used alone!
MAO-B inhibitors ex
Selegiline (Eldepryl)
Rasagiline (Azilect)
MAO-B inhibitors teaching
decrease protein to 40g/day
avoid foods containing tyramine
MAO-B inhibitors adverse effects
tachy/bradycardia, dyskinesia, hypotension
Potentially fatal reaction when taken with opioids
Anticholinergics contraindications
narrow-angle glaucoma, myasthenia gravis, GI obstruction
Anticholinergics adverse effects
dry mouth
GI upset (take with food)
photo-sensitivity
benztropine mesylate (Cogentin) category
anticholinergic
benztropine mesylate (Cogentin) use
early parkinson’s
benztropine mesylate (Cogentin) adverse effects
blurred vision, urinary retention, dry mouth, constipation, photophobia, tachycardia, glaucoma
Can’t see, can’t pee, can’t spit, can’t shit
Acetylcholinesterase (AchE) Inhibitors use
AD tx
Acetylcholinesterase (AchE) Inhibitors examples
Donepezil hydrochloride (Aricept)
Galantamine (Reminyl)
Tacrine (Cognex)
Rivastigmine tartrate (Exelon)
Acetylcholinesterase (AchE) Inhibitors function
Prevent breakdown of acetylcholine
Enhances transmission in cholinergic neurons
AChE Inhibitors considerations
Monitor for hypotension
no glaucoma
Administer between meals (unless GI upset)
monitor LFT’s
AChE Inhibitors overdose sx
Severe nausea/vomiting, sweating, salivation, hypotension
Bradycardia, convulsions, increased muscle weaknesses (including respiratory muscles)
donepezil hydrochloride (Aricept) category
Acetylcholinesterase (AChE) Inhibitors
donepezil hydrochloride (Aricept) adverse effects
n/v, dizziness , HA, bronchoconstriction, liver injury (tacrine/Cognex)
Cholinergic effects- “SLUDGE”
Salivation, Lacrimation, Urination, GI distress
