Drugs for Neurological disorders: Parkinson's and Alzheimer's Flashcards
Symptoms of Parkinsonism include
- Involuntary tremors of the limbs
- rigidity of muscles
- slowness of movement (bradykinesia)
- Postural changes
- Shuffling walk
- Lack of facial expression
- Pill-rolling motion of the hands
Parkinson’s is the resulting effect of degeneration of ________ neurons
dopamine
Drug classes used to treat Parkinsonism include
- anticholinergics
- block cholinergic receptors
- dopamine replacements
- convert to dopamine
- dopamine agonists
- stimulate dopamine receptors
- MAO-B inhibitors
- inhibit MAO-B enzyme that interferes with dopamine
- COMT inhibitors
- inhibit COMT enzyme that inactivates dopamine
Anticholinergic drugs that treat Parkinsonism are
- Benztropine
- Trihexyphenidyl HCL
Both decrease tremors and rigidity
Nursing interventions for anticholinergics are
- Monitor urine output
- moniter VS
- Increase fluid intake, fiber, and exercise
- Encourage client to relieve dry mouth with ice chips, hard candy, or sugarless gum
- suggest use of sunglasses for photophobia
- Observe for involuntary movements
- Advise client to avoid alcohol, cigarettes, caffeine and aspirin
Dopaminergic drugs used to treat Parkinsonism are
carbidopa-levodopa
*dopamine cannot cross the BBB, carbidopa allows more levodopa to reach the brain by preventing its conversion to dopamine in the periphery
The effect of carbidopa-levodopa is
increased mobility
The side effects of dopaminergics are
- Fatigue, insomnia
- Dry mouth
- Blurred vision
- Orthostatic hypotension
- palpitations, dysrhythmias
- Urinary retention
- Nausea, vomiting
- Dyskinesia, psychosis, severe depression
What are some teaching points for Anticholinergic drugs for Parkinson’s?
- Relieve dry mouth with ice chips, hard candy, or sugarless gum.
- Use sunglasses to relieve photophobia
- Void before taking medication to avoid urinary retention
- Have routine eye exams to check for glaucoma (contraindicated for anticho)
- Avoid alcohol, caffeine, aspirin, and cigarettes to avoid gastric acidity
- Diet high in fiber and increased fluid intake (constipation)
What are some nursing considerations for anticholinergics for Parkinson’s?
- Health Hx - report glaucoma, GI dysfunction, urinary retention, angina pectoris and myasthenia gravis
- Drug Hx - report contraindicated phenothiazines
- Baseline VS
- Basline I/O
- Assess pt knowledge of meds
Contraindications for carbidopa-levodopa include
- Narrow-angle glaucoma
- severe cardiac, renal, and hepatic disease
- suspicious skin lesions
Carbidopa-levodopa action in the body is
to convert to dopamine in the brain
The action of amantadine is
- stimulate dopamine receptors
- it is an antiviral
- drug tolerance develops
The action of MAO-B inhibitors is
To inhibit the enzyme monoamine oxidase-B which breaks down dopamine
The MAO-B inhibitor drug for Parkinsonism is
Selegiline
