CHAPTER FOURTY-EIGHT PARKINSONS Flashcards
what is parkinsons
chronic, progressive, degenerative disorder of CNS
-seen in resting tremor, bradykinesia (slow movement), rigidity and postural instability
-cause of nerve cell damage is unknown
-decrease in dopamine and increase in Ach (in basal ganglia)
treatment: dopamine receptor agonists and COMT inhibitors
what kind of drug is levodopa-carbidopa
dopamine receptor agonist
-absorbed in small intestine (PO)
-increases dopamine in the brain (levodopa is precursor to dopamine)
-treatment for parkinsons
adverse effects of dopamine receptor agonists
headache, anxiety, hallucinations, increase and decrease in HR, decrease in BP, loss of appetite, nausea, vomiting, teeth grinding
-effects CNS, cardiovascular, and GI
contraindications of dopamine receptor agonists
hypersensitivity, glaucoma, melanoma, cardiovascular, pulmonary, renal, hepatic, endocrine, GI and hypertension issues
other dopamine receptor drugs other than levodopa-carbidopa
amantadine, pramipexole, ropinirole, selegeline
what kind of drug is ropinirole
dopamine receptor drug
-stimulates
-can be used with levodopa
-absorbed orally with 1-2 hour peak
-concentration of 2 days
-half life is 6 hours
what kind of drug is tolcapone
Catechol-o-methyltransferase COMT
-absorbed rapidly and protein bound
-2-3 hour half life
-crosses placenta
-inhibits the metabolism of levodopa
-treats parkinsons, if no improvement discontinue in three weeks
adverse effects of COMT
CNS, cardiovascular, GI, respiratory, liver function
-entracapone is newer and safer
contraindications of COMT
hypersensitivity, liver disease, rhabdomyolysis (muscle breakdown), hyperpyrexia, confusion, use of MOAI
levodopa carbidopa and entracapone
COMT and decarboxylase inhibitor
-allows for higher levels of levodopa leading to more dopamine
-treats parkinsons
adverse effect of COMT and decarboxylase inhibitor
GI swelling, somnolence (lethargic), dyskinesia (unusual movement) and teeth grinding
contraindications with COMT and decarboxylase inhibitor
sensitivity, use of MAOI, melanoma, fibrotic complications
what kind of med is atropine sulfate
made from belladonna alkaloid/muscarinic antagonist
-blocks effect of Ach at muscarinic receptors
-uses: bradycardia, preoperatively, eye drops (dilation and relive swelling) and an antidote
- other drugs in class: nebulizers and motion sickness meds
adverse effects of belladonna meds
cardiovascular, CNS, GI and GU
contraindications of belladonna meds
sensitivity, glaucoma, ulcers, obstruction, asthma, bladder obstruction, hepatic and renal issues
what kind of drug is benztropine mesylate
central acting anticholinergics
-selective on muscarinic receptors
-crosses blood brain barrier
-treats imbalance of cholinergic and dopaminergic neurotransmission (parkinsonism)
adverse effects of central acting anticholinergics
CNS, cardiovascular, general muscle group issues
contraindications of central acting anticholinergics
glaucoma, GI, myasthenia gravis, cardiovascular issues
what kind of drug is dicyclomine hydrochloride
gastrointestinal anticholinergics
-GI muscle relaxant, blocks muscarinic receptors
-treats IBS
adverse effects of gastrointestinal anticholinergics
CNS, GI, GU
contraindications of gastrointestinal anticholinergics
glaucoma, ulcers, asthma, bladder obstruction, renal and hepatic issues, prostate issues, myasthenia gravis
what kind of drug is oxybutynin
urinary antispasmodics/antimuscarinic
-acts on smooth muscle and inhibits muscarinic receptors
-treats bladder instability
- shouldn’t be crushed
adverse effects of urinary antispasmodics/antimuscarinics
CNS and GI
contraindications of antispasmodics/antimuscarinics
sensitivity, GI, glaucoma, myasthenia gravis, cardiovascular issues, urinary retention
