chapter 21 & 23 neuro musc meds Flashcards
what is the definition of neurodegenerative diseases**
progressive irreversible loss of neuron function in the brain and or spinal cord
what is a common problem with neurodegenerative diseases **
depression
what are signs and symptoms of parkinson’s disease
tremors
muscle rigidity
Bradykinesia (slow movement)
postural instability
what is the pathophysiology of parkinson’s disease
it is caused by a lack of dopamine production from the substantia nigra and since there is a lack of dopamine AcH has a more dramatic effect
what is the goal of pharmacotherapy for parkinson’s disease **
the goal is to balance dopamine and acetylcholine
how long may a pt have to wait until the see benefits of parkinson’s disease pharmacotherapy **
may take 2-3 weeks to see benefits
what are the two main general classes of drugs that are used to treat parkinson’s disease***
Dopamine agonists
Anticholinergics
what is a major adverse effect that can result from a lack of dopamine in striatum and what is it ***
Major adverse effect of this is Extrapyramidal symptoms which are basically the same as symptoms of parkinson’s disease
what is the most effective pharmacotherapy to treat parkinson’s disease with its brand name
Dopamine (levodopa)
what type of food should you avoid while taking levodopa**
avoid multivitamins with B6 and high protein diets
what are 4 things that should be monitored while taking levodopa **
-ANS vital signs
-safe ambulation (due to dizziness)
-liver and kidney function
-behavioural changes (aggression/ confusion)
what is more effective levodopa or dopamine agonists
levodopa but dopamine agonists are used as combo therapy with levodopa
what type of drug is pramipexole
dopamine agonist
what are 3 considerations for pramipexole **
-monitor for orthostatic hypotension
-monitor for tardive dyskinesia (abnormal movements)
-sleep attacks
what is the prototype anticholinergic drug**
Benztropine
What are adverse effects of Benztropine***
Think about anticholinergic so reduces the effect of the rest and digest
-sedation
-constipation
-blurred vision
-dry mouth
-decreased sweating
-urinary retention
-confusion
what is a serious adverse effect of benztropine ***
paralytic ileus (paralyzed intestine)
what are the contraindications for benztropine**
Think what will happen when you block the rest and digest and fight or flight takes over
-narrow angle glaucoma
-myasthenia gravis*
-tardive dyskinesia*
-gi/urinary obstruction
-prostatic hypertrophy*
-peptic ulcers
-tachycardia
-NO alcohol*
what drugs can cause added toxicity to benztropine***
-antihistamines
-tricyclic antidepressants
-phenothiazines
-MAOI’s
-quinidine
what are 3 drug interactions that can occur with benztropine **
-drugs that create additive toxicity
-drugs that have and additive sedative effect
-any drugs that slow GI motility/decrease
what pregnancy category is benztropine ***
Category C
what is the treatment for anticholinergic intoxication/overdose**
physostigmine 1-2 mg subcutaneous or IV
how effective is the pharmacotherapy of alzheimer’s disease **
it only produces modest results and is ineffective at stopping the progress of the disorder
