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Block 2 Week 8 Neurological > DONE: Drugs: Acetylcholinesterase Inhibitors > Myasthenia Gravis & Dopaminergic > Parkinson's Disease > Flashcards

DONE: Drugs: Acetylcholinesterase Inhibitors > Myasthenia Gravis & Dopaminergic > Parkinson's Disease Flashcards

0
Q

This medication can cause bronchospasm, hypotension, bradycardia, and cardiac arrest. Atropine sulfate is the antidote so it’s telling you that this is an acetylcholine medication.

A

Edrophonium Chloride / Tensilon

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1
Q

Impaired postural reflexes is considered the most common symptom of Parkinson’s, onset is gradual and insidious. This meaning it kind of creeps up on you. Rigidity is increased resistance to passive motion.

A

Parkinson’s Disease

Study Tip: Passive Motion actions include:
Ex????

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2
Q

This medication may work as a Dopamine agonist but we are not sure, this is a medication that you don’t see given to patients often, just to some patients. What is the name of this medication?

A

Amantadine Hydrochloride / Symmetrel

[Anti-Viral]

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3
Q

Dopamine can’t cross the blood brain barrier, so Levodopa which is a precursor of Dopamine can cross the blood brain barrier and it crosses the blood brain barrier so that the patient will have more Dopamine.
What neurological disorder does this medication treat?

A

Parkinson’s Disease

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4
Q

The nurse must administer the medication with low-protein foods because it is HIGHLY protein bound, so it is best to give it during what time of the day? What medication has this nursing interventions?

A

Before meals or AC

Carbidopa/Levodopa / Sinemet
[Dopaminergic Agent]

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5
Q 
Hypotension
Bradycardia
Respiratory depression
Bronchospasm.
What medication has these adverse effects?
A

Pryridostigmine Bromide / Mestinon

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6
Q

What are the two most commonly used MAO-B Inhibitors used to treat Parkinson’s Disease?

A
  1. Rasagiline / Azilect
  2. Zydis Selegiline / Zelpar
    - disintegrating tablets
    [MAO-B Inhibitors]
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7
Q

As a result of the actions of Myasthenia Gravis medications there’s more Acetylcholine in the blood to re-activate ___________ receptors and promote increased muscle contraction.

A

Cholinergic

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8
Q

If the patient has too much or an overdose of Acetylcholine it will present very similar to Myasthenia Gravis with what three common clinical manifestations?

A

Skeletal Muscle Weakness
Dyspnea
Dysphagia

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9
Q

The nurse must educate the patient to wear a Medic-Alert bracelet. This is considered a lifelong medication therapy. This is not a disease that can be cured by the _______ medication.

A

Pryridostigmine Bromide / Mestinon

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10
Q

This neurological disorder is characterized by slowness of initiation and the execution of skeletal muscle movements. Their movements are very deliberate, they have increased muscle tone which means they have a stiff appearance. What medication have these clinical manifestations?

A

Parkinson’s Disease

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11
Q

So the nurse will give IV _______ because we have somebody that’s having these symptoms and we don’t know if it’s Myasthenia Gravis or not. If they get better and they’re better for about 5 minutes then that says you have Myasthenia Gravis, if they are in a cholinergic crisis then this medication will make their symptoms worse!!!

A

Edrophonium Chloride / Tensilon

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12
Q

Avoid foods high in Vitamin _____ because it can actually interfere with the effects of the medication so you need to avoid foods like _______, _______, and _______.
What medication has this patient teaching as a nursing intervention?

A

B6

Lima beans
Kidney beans
Cereal

Carbidopa/Levodopa / Sinemet
[Dopaminergic Agent]

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13
Q

This is an autoimmune neuromuscular disease. In this disorder the antibodies attack acetylcholine receptors on the cell membrane. This causes a deficient ACh transmission at the myoneural junction. What neurological disorder is this?

A

Myasthenia Gravis

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14
Q

The nurse must instruct the patient to eat 45-60 minutes after taking ________ medication although they can eat a SMALL amount of food with the medication to avoid GI upset.

A

Pryridostigmine Bromide / Mestinon

Study Tip: They eat 45-60 minutes after being given the medication to reduce risk for aspiration. Remember that Myasthenia Gravis effects swallowing.

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15
Q

Degeneration of dopaminergic neurons in the Substantia Nigra of the midbrain.
Imbalance of the neurotransmitters
Dopamine (DA) [inhibitory] and
Acetylcholine (ACh) [excitatory]
This is the pathophysiology of what neurological disorder?

A

Parkinson’s Disease

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16
Q

Anorexia
Nausea
Vomiting
What medication has these side effects?

A

Carbidopa/Levodopa / Sinemet

[Dopaminergic Agent]

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17
Q

Remember one of the areas that’s depressed in the disease Myasthenia Gravis is Respiratory so if you don’t give _________ medications on time your patient could stop breathing.

A

Anti-Cholinesterase

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19
Q

The medications that are used to treat Myasthenia Gravis are therapeutically classified in what three classifications?

A

Acetylcholinesterase inhibitor
Cholinesterase inhibitors
Anti-cholinesterase medications

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19
Q

This medication is used to diagnose Myasthenia Gravis, because if a patient has weakness we give them _________ and they have an improvement in their muscle tone for very quickly within 30-60 seconds because we gave it IV. It only lasts for about 5 minutes, so it’s not effective for treatment because you can’t keep giving people medication IV every 5 minutes which is what you need.

A

Edrophonium Chloride / Tensilon

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20
Q

Resting tremor. Tremor can involve the ______, ______, ______, and ______ but it does NOT often cause shaking of the head. This is VERY VERY key a very obvious symptom of what neurological disorder?

A 
Hand
Diaphragm 
Lips
Jaws
Parkinson's Disease
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22
Q

__________ is not usually used as a first line drug for patients under 65 because long-term use does come along with some complications like dyskinesia and fluctuations of liver functions. So usually you wait until someone is older, although if nothing else is working they will use it for younger patients, but it’s just NOT the first choice.

A

Carbidopa/Levodopa / Sinemet

[Dopaminergic Agent]

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23
Q

_________ are also known as Anticholinesterase Medications and they are used to treat Myasthenia Gravis.

A

Anti-myasthenics

Study Tip: These medications inhibit the cholinesterase enzyme.

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24
Q

What are the two most commonly used COMT Inhibitors used to treat Parkinson’s Disease?

A
  1. Tolcapone / Tasmar
  2. Entacapone / Comtan
    [COMT Inhibitors]
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25
Q

What is the name of the medication used to test for Myasthenia Gravis?

A

Edrophonium Chloride / Tensilon

Study Tip: This is the Tensilon Test.

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26
Q

There is a higher amount of ACh > than DA
There is more Acetylcholine than Dopamine causing ACh to be unopposed which leads to the symptomatic movements associated with this disease process.
This is the pathophysiology of what neurological disorder?

A

Parkinson’s Disease

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27
Q

Make administering ________ a high priority when administering medications in order of acuity because the nurse should know that these medications must be given ON TIME and which alternate medications you can give a half an hour before or after.

A

Anti-Cholinesterase

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28
Q

The neurological disorder Parkinson’s Disease can be drug induced by the patient using what 4 drugs?

A

Lithium
Haldol
Aldomet
Amphetamines > Illicit Drugs

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29
Q

__________ crosses the blood-brain barrier to become converted into dopamine. The __________ part of the drug blocks conversion of the first part of the medication into Dopamine in the Peripheral Nervous System until the ________ crosses the blood-brain barrier and enters the Central Nervous System.
What medication have these pharmacodynamics?

A 
Levodopa
Carbidopa
Levodopa
Carbidopa/Levodopa / Sinemet 
[Dopaminergic Agent]
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30
Q

If the patient is in a Cholinergic Crisis giving the patient the medication _______ is going to make the symptoms WORSE.

A

Edrophonium Chloride / Tensilon

Study Tip: That’s really something you need to understand and to remember!!!
REMEMBER > THIS MEDICATION ADDS MORE ACETYLCHOLINE TO A PATIENT THAT ALREADY HAS TOO MUCH ACETYLCHOLINE!

31
Q

If you think back to the lecture on the Autonomic Nervous System and what acetylcholine does, then you would know that Acetylcholinesterase inhibitors are __________ so anything that the parasympathetic system does is what it’s going to be enhancing.

A

Parasympathomimetic

32
Q

Parkinson’s Disease causes the breakdown of Dopamine, so the _________ medication prevents Dopamine from being broken down.

A

Monoamine Oxidase B Inhibitors [MAO-B inhibitors]

33
Q 
Involuntary movements
Orthostatic hypotension
Urinary retention
Psychosis
Agranulocytosis 
What medication has these adverse effects?
A

Carbidopa/Levodopa / Sinemet

[Dopaminergic Agent]

34
Q

The nurse knows that __________medication must be given/taken ON TIME to prevent major complications of Myasthenia Gravis

A

Pryridostigmine Bromide / Mestinon

36
Q

The ___________ medications inhibit the enzyme that breaks down Acetylcholine and this prolongs the effect of Acetylcholine at the Neuromuscular junction. THIS MEDICATION HAS TO BE GIVEN ON TIME.

A

Anti-Myasthenics / Anti-Cholinesterase

37
Q

During Parkinson’s Disease the neurotransmitter Catechol O-methyltransferase inactivates Dopamine so by giving _______ medication this prevents that decrease in Dopamine from happening.

A

COMT Inhibitors

38
Q

______ and _______ are also on the list of meds to give on time. Administering Anti-Myasthenics and Anti-Cholinesterase medications supersedes giving a ______ medication since not giving this medication could essentially kill the patient.

A

Insulin
Antibiotics
Pain

39
Q

_________ crosses the blood brain barrier and once it has crossed the barrier the _________ in the medication is released and it prevents the first medication from being converted into Dopamine once it passes the blood brain barrier. What medication have these pharmacodynamics?

A

Levodopa
Carbidopa
Carbidopa/Levodopa / Sinemet
[Dopaminergic Agent]

40
Q

Prevents destruction of acetylcholine and increases acetylcholine blood levels, and remember back to again the autonomic nervous system drugs.
What medication has this mode of action?

A

Pryridostigmine Bromide / Mestinon

41
Q

Instruct the patient with ________to take their Anticholinesterase medication with a small amount of food, because it can cause some GI discomfort.

A

Myasthenia Gravis

42
Q

These medications increase the Dopamine levels of the blood. The medication Carbidopa/Levodopa / Sinemet which is a combination medication is one that you see given very commonly to increase Dopamine in the blood.
This medication is used to treat what neurological disorder?

A

Parkinson’s Disease

44
Q

The nurse needs to educate the patient that their urine and sweat may be dark while taking this medication. It is harmless but it can stain their clothes so the nurse will want to WARN the patient of that.
What medication has this patient teaching as a nursing intervention?

A

Carbidopa/Levodopa / Sinemet

[Dopaminergic Agent]

45
Q

How do anticholinesterase / antimyasthenic medications help patients with Myasthenia Gravis regain muscle contractility?

A

These medications make more Acetylcholine available in the blood to activate Cholinergic receptors and promote muscle contraction by decreasing the amount of Cholinesterase in the blood which usually gets rid of any extra Acetylcholine in the blood.

46
Q

The Cabidopa is meant to keep that Levodopa from becoming _______ UNTIL AFTER it crosses the blood brain barrier. This is actually a smart drug, it knows when it’s supposed to do what it’s supposed to do.
What medication have these pharmacodynamics?

A

Dopamine
Carbidopa/Levodopa / Sinemet
[Dopaminergic Agent]

47
Q

The Anticholinesterase / Anticholinergic medications inhibit cholinesterase, making acetylcholine highly available.
The nurse will monitor the patient for signs and symptoms of medication overdose which is a _______ because they have too much acetylcholine. And under dosing which is a ________, which unfortunately these look very similar.

A

Cholinergic Crisis

Myasthenic Crisis

48
Q

Something that can be a clue to the nurse that the patient is having an _______ on the Anticholinesterase medication is that they are in a Cholinergic Crisis and the symptoms are probably going to start within an hour after receiving the medication.

A

Overdose

50
Q

The nurse needs to instruct the patient patient taking a medication for ______ to take their medications ON TIME, to keep the blood level where it needs to be preventing muscle weakness. Weakness can cause a problem in the patient’s ability to chew, swallow, and to breathe. If they have difficulty swallowing they are at risk for ________ and _________ as well.

A

Myasthenia Gravis
Aspiration
Pneumonia

52
Q 
Eyelids
Chewing
Swallowing
Speaking
Breathing
The skeletal muscles related to these actions are most often affected during what neurological disorder?
A

Myasthenia Gravis

53
Q

The nurse must monitor the patient on this medication for Orthostatic Hypotension.
What medication has this nursing interventions?

A

Carbidopa/Levodopa / Sinemet

[Dopaminergic Agent]

54
Q

This medication increases ACh levels which
increases the activation of the Cholinergic or SLUD response.
What medication has this mode of action?

A

Pryridostigmine Bromide / Mestinon

Study Tip: Salivation, Lacrimation, Urination, and Defecation
and what else is activated??? ASK ARBOGAST?

54
Q

Chemical intoxication by things like carbon monoxide or manganese oxide can cause the neurological disorder _________.

A

Parkinson’s Disease

55
Q

There’s a test using a medication called the _______ and we administer this medication to diagnose Myasthenia Gravis. This medication is given IV. If the results are positive the patient will regain muscle strength for about 5 minutes.

A

Tensilon Test

Study Tip: The medication administered is called Edrophonium Chloride / Tensilon.

56
Q

This is a progressive degenerative disease caused by the depletion of dopamine in the brain. This most often develops after the age of 50 and a lot of times patients have other chronic conditions also. What neurological disorder is this?

A

Parkinson’s Disease / PD

56
Q

In about 5 years after a patient is diagnosed the neurological disorder __________ they cannot swing their arms anymore, they might be able to blink only 2-6 times a minute, they can have dandruff, and very greasy skin.

A

Parkinson’s Disease

Study Tip: The nurse needs to instill eye drops to prevent dry eyes in these patients.

59
Q

Administer this medication based on patient’s at home medication administration schedule.
What medication has this nursing intervention?

A

Carbidopa/Levodopa / Sinemet
[Dopaminergic Agent]

Study Tip: If they take it a 2:45 in the afternoon at home then that’s when you want to give it in the hospital

60
Q

What is the most commonly used antiviral medication used to treat Parkinson’s Disease?

A

Amantadine Hydrochloride / Symmetrel

[Anti-Viral]

61
Q 
Skeletal Muscle weakness
Dyspnea
Dysphagia
Drooling
Bradycardia
Abdominal cramping
Increased tears
Sweating
What medication has these side effects?
A

Pryridostigmine Bromide / Mestinon

61
Q

What is the difference between a Cholinergic Crisis and a Myasthenic Crisis?

A

NKA

61
Q

The neurological disorder ________ can be caused by Encephalitis Type A.

A

Parkinson’s Disease

62
Q

The patient with _________should wear a medical alert bracelet since they will be on their medication for LIFE. Also we want to evaluate the effectiveness. The antidote for a patient in a cholinergic crisis is ________.

A

Myasthenia Gravis
Atropine

Study Tip: Think back to medications affecting the ANS and that will make sense to you.

65
Q

Dopamine producing neurons in the _________ of the midbrain have _________ in Parkinson’s Disease and this disrupts the normal balance between Dopamine and Acetylcholine. This causes an
_______ of acetylcholine and dopamine in the CNS.

A

Substantia Nigra
Degenerated
Imbalance

65
Q 
Hydrocephalus
Hypoxia
Infections
Stroke
Tumor
Trauma
These can cause the onset of the neurological disorder \_\_\_\_\_\_\_\_\_\_\_.
A

Parkinson’s Disease

65
Q

This medication crosses the blood brain barrier and then is converted into Dopamine, because remember Dopamine does not cross the blood brain barrier so we can’t give them Dopamine but we can give them ________ which is a precursor of Dopamine.
What medication has this mode of action?

A

Levodopa
Carbidopa/Levodopa / Sinemet
[Dopaminergic Agent]

66
Q

There will usually be a dosage of 50/25 which means 50mg/25mg which means 50mg of the first medication and 25mg of the of the second medication.
What medication has these pharmacodynamics?

A

Carbidopa/Levodopa / Sinemet

Study Tip: There is also a dosage of 25 mgs of Carbidopa and 100 mgs of Levodopa.

66
Q

The nurse needs to educate the patient that they can NOT abruptly stop medication.
What medication has this patient teaching as a nursing intervention?

A

Carbidopa/Levodopa / Sinemet

[Dopaminergic Agent]

67
Q

The medication Carbidopa/Levodopa / Sinemet is used to relieve tremors and rigidities associated with it’s usage by increasing the amount of Dopamine in the body.
What neurological disorder does this medication treat?

A

Parkinson’s Disease

68
Q

The nurse needs to remember side effects are things that are not _______ and adverse reactions are things that can be _______.

A

Pleasant

Harmful

70
Q

This medication improves fatigue in Parkinson’s Disease and Multiple Sclerosis and also decreases dyskinesia?

A

Amantadine Hydrochloride / Symmetrel
[Anti-Viral]

Study Tip: FDA approved for what????

71
Q

What is the definition of a granulocyte?

What is the definition of agranulocytosis?

A

Granulocytes are a type of White Blood Cell.
Agranulocytosis means it decreases those WBCs and a actually means without which means it can cause a patient to have a life threatening infection.

71
Q

The nurse must monitor the patient on this medications vital signs and EKG. The patient doesn’t have to be on Telemetry if they have been taking the medication, but you do want to do a 12 lead EKG while you’re initiating or changing mediation therapy.
What medication have these nursing interventions?

A

Carbidopa/Levodopa / Sinemet

[Dopaminergic Agent]

71
Q

What are the three most commonly used Dopamine Agonists used to treat Parkinson’s Disease?

A
  1. Pramipexole / Mirapex
    - Extended Release (Given Daily)
  2. Ropinirole / Requip
    - Extended Release (Given Daily)
  3. Rotigotine / Neupro

[Dopamine Agonists]

71
Q

_________ is the name of the medication used to treat Parkinson’s Disease that was taken off market from 2008- 2012 because they found that the medicine was crystallizing in the patch so the medication was not giving a dose to the patients. It was off the market for four years until the company corrected the problem

A

Rotigotine / Neupro

[Dopamine Agonists]

72
Q

_________ stimulate Dopamine receptors on the cell membrane so the body thinks there is more Dopamine present. This therapeutic classification of medication be taken in combination with Levodopa or Anticholinergic drugs.

A

Dopamine Agonists

Block 2 Week 8 Neurological (14 decks)

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