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
does pharmacotherapy for alzheimer’s disease promote the PNS or SNS
promotes the functioning of the PNS
what is the main cholinesterase inhibitor with its brand name **
Tacrine (cognex)
what is the main adverse effect of Tacrine (cognex) **
GI system is heavily affected
what is the prototype reversible cholinesterase inhibitors **
Donepezil
which drug has less side effects donepezil or tacrine***
Donepezil has fewer side effects
what are some serious adverse effects of donepezil **
dysrhythmias
seizures
renal failure
how do you treat a anticholinesterase overdose**
anticholinergic drugs
what is the pathophysiology of MS **
characterized by demyelination of neurons secondary to an inflammatory response
what is the leading cause of neurological disability in the 20-40 age group **
MS
what is the only approved drug for ALS treatment with its brand name
Riluzole (rilutek)
what are the three classed of drugs that are used to treat muscle spasms **
-NSAIDS
-muscle relaxants
-centrally acting muscle relaxants
what is the prototype central acting skeletal muscle relaxant**
Cyclobenzaprine
what are 4 drugs similar to cyclobenzaprine **
Methocarbamol
Metaxalone
Orphenadrine
tizanidine
What is methocarbamol used for**
central sedative effects that reduce spasms and as an adjunct to physical therapy (robaxin)
what is metaxalone used for**
relief of muscle spasms but is an ineffective treatment for spasticity related to neurological disorders
what is orphenadrine used for **
relief of muscle spasms because it causes prominent anticholinergic effects
What is Tizanidine used for **
relief of spasticity related to brain or spinal cord injuries
what causes irritable deep tendon reflexes and scissoring movements of lower extremities muscle spasms or spasticity?
Muscle spasticity
what is the therapeutic classification of dantrolene***
Direct acting skeletal muscle relaxant that is effective against spacticity
what is especially important to monitor when a pt is taking dantrolene **
Liver function
what herbal remedies can help muscle spasms and spasticity**
Black cohosh
Castor oil
Capsaicin
what vitamin can help with muscle spasms and spasticity**
Vitamin B6
