Degenerative Disease Drugs Flashcards

1
Q

Symptoms of Parkinson’s’

A
  1. Tremors
  2. Muscle rigidity
  3. Bradykinesia
  4. Postural instability
  5. Affective flattening
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2
Q

Parkinson’s

-Health Problems

A
1. Primarily affects muscle movement
Pt's often experience other health issues:
-Anxiety and depression
-Sleep disturbances
-Dementia
-Autonomic nervous system disturbances
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3
Q

Parkinson’s

-Cause of Symptoms

A
  1. Degeneration and destruction of dopamine-producing neurons
    in the SUBSTANTIA NIGRA portion of the brain
  2. Corpus stratum
    - normally controls unconsciousness muscle movement
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4
Q

Parkinson’s

-Part of the brain responsible to symptoms

A

Substantia nigra

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5
Q

Parkinson’s

-Neurotransmitters involved?

A
  1. Dopamine and acetylcholine in corpus striatum
    - affect balance, posture
    - affect muscle tone, involuntary movement
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6
Q

Parkinson’s

-Drug therapy action

A
  1. Restores dopamine function
  2. Blocks acetylcholine
  3. Extrapyramidal side effects (EPS
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7
Q

Extrapyramidal side effects?

A

Symptoms of:
1. Acute dystonia, akathisia, parkinsonism, and tardive dyskinesia
often caused by antipsychotic drugs

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8
Q

Anti-parkinsonism Agents

A
  1. Restore balance of dopamine and acetylcholine in brain
  • Dopaminergic drugs
  • Anti-cholinergics
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9
Q

Dopaminergic Drug Therapy

-Monitor/Contraindications

A
  1. Monitor hypotension and tachycardia
  2. Look for signs of drug toxicity
  3. Contraindicated in narrow-angle glaucoma
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10
Q

Dopaminergics

-Action

A
  1. Restore balance of dopamine and acetylcholine
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11
Q

Dopaminergic

-Examples

A
  1. Levodopa (Larodopa)

2. Levodopa and Carbidopa (Sinemet)

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12
Q

Dopaminergic Agent

-Prototype Drug

A

Levodopa (Larodopa)

  1. Mechanism:
    - Increases biosynthesis of dopamine w/in nerve terminals
  2. Primary use:
    - Restore dopamine function or stimulate dopamine receptors w/in the brain
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13
Q

Dopaminergic Agents

-Adverse Effects

A

Dizziness, light-headedness, sleep dysfunction, fatigue, nausea, vomiting, constipation, orthostatic hypotension, dystonia, dyskinesia

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14
Q

Levodopa (Larodopa)

-Prototype Dopaminergic Drug

A
  1. Increases biosynthesis of dopamine w/in nerve terminals

2. Effectiveness boosted by combining w/ carbidopa (SINEMET)

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15
Q

Dopaminergic Agents:

-Pt Teaching

A
  1. Increase fiber and fluids
  2. Avoid food and drugs high in PYRIDOXINE
  3. May take several months for full effect
  4. Abruptly stopping the drug may cause Parkinsonism crisis
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16
Q

Dopaminergic Adjunct Agent

-Inhibit Enzymes??

A

Tolcapone (tasmar)

17
Q

Dopaminergic Adjunct Agent

-Activate dopamine receptors (Dopamine agonists)

A

Ropinirole (Requip)

18
Q

Dopaminergic Adjunct Agent

-Cause Dopamine release from Nerve Terminals

A

Amantadine (Symmetrel)

19
Q

Anticholinergic Agents

-Overview

A
  1. Centrally acting
  2. Block acetylcholine
    - Inhibits overactivity in brain
  3. Used in Early stages
20
Q

Anticholinergic Examples

A
  1. Benztropine mesylate (Cogentin)

2. Triexyphenidyl hydrochloride (Artane)

21
Q

Anticholinergic Agent

-Prototype Drug

A

Benztropine Mesylate (Cogentin)

  1. Mechanism:
    - Block acetylcholine; inhibit overactivity in brain
  2. Primary Use:
    - In early stages of disease
  3. Adverse effects: (SYMPATHETIC EFFECTS)
    - Dry mouth, blurred vision, photophobia, urinary retension, constipation, tachycardia glaucoma
22
Q

Anticholinergic Agent

  • Benztropine mesylate (Cogentin)
  • Adverse effects
A

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

23
Q

Anticholinergic

-Patient teaching

A
  1. Relieve dry mouth w/ frequent drinks or sugarless hard candy
  2. Take w/ food or milk to prevent GI upset
  3. Avoid alcohol
  4. Wear dark glasses; avoid bright sunlight
  5. Do not stop taking abruptly
24
Q

Degenerative Disease Drugs

-Assessment

A
  1. Monitor VS and lab tests
  2. Complete health and drug hx
  3. Severity of disease
  4. Client/ family knowledge of disease
25
Q

Degenerative Disease Drugs

-Nursing Dx

A
  1. Risk for falls
  2. Deficient knowledge RT drug therapy
  3. Deficient knowledge RT disease process
  4. Impaired physical mobility
  5. Self-care deficit
  6. Constipation
26
Q

Degenerative Disease Drugs

-Planning (Goals)

A
  1. Increased ease of movement
  2. Decrease in symptoms
  3. Understanding of drug regimen/disease
  4. Adherence to drug regimen
  5. Reporting side effects
27
Q

Degenerative Disease Drugs

-Implementation

A
  1. Monitor VS and labs
  2. Ensure safety
  3. Monitor behavior changes
  4. Observe symptoms of OD
  5. Monitor improved functional status
  6. Monitor Drug side effects