Chapter 20

Question 1

How is Alzheimer’s diagnosed

Answer 1

PET scan

Question 2

Parkinson’s Disease ANS symptoms

Answer 2

decreased tears, sexual function, orthostatic hypotension, cardiac dysrhythmias, constipation incontinence, heat intolerance

Question 3

Anticholinergics use

Answer 3

parkinson’s-early stage

Question 4

Anticholinergics function

Answer 4

Blocks acetylcholine

Inhibits overactivity in brain

Question 5

Triexyphenidyl hydrochloride (Artane) and Benztropine mesylate (Cogentin)
 category

Answer 5

Anticholinergics

Question 6

Dopaminergics

Answer 6

ex: levodopa
#1 tx

Question 7

Dopaminergics contraindications

Answer 7

narrow-angle glaucoma & undiagnosed skin lesions

Question 8

Dopaminergics teaching

Answer 8

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

Question 9

Dopaminergic use

Answer 9

inhibit enzymes that destroy levodopa or directly activate dopamine receptor in the brain

Question 10

Dopaminergic adverse effects

Answer 10

nausea/vomiting, dyskinesias, postural hypotension, psychosis, dark urine and sweat, activation of malignant melanoma

Question 11

Dopaminergic Adjunct Agents cautions

Answer 11

Liver function impairment

increases K+ and BUN

Question 12

Dopaminergic Adjunct Agents adverse effects

Answer 12

convulsions, shock

Question 13

Dopaminergic Adjunct Agents examples

Answer 13

Bromocriptine (Parlodel)
Ropinirole (Requip)
Pramipexole (Mirapex)
Pergolide (Permax)

Question 14

MAO-B inhibitors use

Answer 14

parkinson’s
Enhance effects of L-dopa
not used alone!

Question 15

MAO-B inhibitors ex

Answer 15

Selegiline (Eldepryl)

Rasagiline (Azilect)

Question 16

MAO-B inhibitors teaching

Answer 16

decrease protein to 40g/day

avoid foods containing tyramine

Question 17

MAO-B inhibitors adverse effects

Answer 17

tachy/bradycardia, dyskinesia, hypotension

Potentially fatal reaction when taken with opioids

Question 18

Anticholinergics contraindications

Answer 18

narrow-angle glaucoma, myasthenia gravis, GI obstruction

Question 19

Anticholinergics adverse effects

Answer 19

dry mouth
GI upset (take with food)
photo-sensitivity

Question 20

benztropine mesylate (Cogentin) category

Answer 20

anticholinergic

Question 21

benztropine mesylate (Cogentin) use

Answer 21

early parkinson’s

Question 22

benztropine mesylate (Cogentin) adverse effects

Answer 22

blurred vision, urinary retention, dry mouth, constipation, photophobia, tachycardia, glaucoma

Can’t see, can’t pee, can’t spit, can’t shit

Question 23

Acetylcholinesterase (AchE) Inhibitors use

Answer 23

AD tx

Question 24

Acetylcholinesterase (AchE) Inhibitors examples

Answer 24

Donepezil hydrochloride (Aricept)
Galantamine (Reminyl)
Tacrine (Cognex)
Rivastigmine tartrate (Exelon)

Question 25

Acetylcholinesterase (AchE) Inhibitors function

Answer 25

Prevent breakdown of acetylcholine

Enhances transmission in cholinergic neurons

Question 26

AChE Inhibitors considerations

Answer 26

Monitor for hypotension
no glaucoma
Administer between meals (unless GI upset)
monitor LFT’s

Question 27

AChE Inhibitors overdose sx

Answer 27

Severe nausea/vomiting, sweating, salivation, hypotension

Bradycardia, convulsions, increased muscle weaknesses (including respiratory muscles)

Question 28

donepezil hydrochloride (Aricept) category

Answer 28

Acetylcholinesterase (AChE) Inhibitors

Question 29

donepezil hydrochloride (Aricept) adverse effects

Answer 29

n/v, dizziness , HA, bronchoconstriction, liver injury (tacrine/Cognex)
Cholinergic effects- “SLUDGE”
Salivation, Lacrimation, Urination, GI distress