EXAM 4- Antiparkisons

Question 1

also called paralysis agitans, is a degenerative disorder of the central nervous system.

Answer 1

parkinson’s disease

Question 2

parkinson’s thought to be caused by

Answer 2

a deficiency of Dopamine and an excess of acetylcholine within the CNS.

Question 3

parkinson’s affects –

Answer 3

the part of the brain that controls muscle movement, causing trembling, rigidity, difficulty walking, and balance problems.

Question 4

dopaminergic drug

Answer 4

These are drugs that affect the Dopamine content of the brain.

Question 5

ex of dopaminergic drug

Answer 5

• Levodopa (Larodopa)
• Carbidopa (Ladosyn)
• Amantadine (Symmetrel)
• Pergolide mesylate (Permax)

Question 6

Dopamine when given by oral route, does not

Answer 6

cross the blood brain barrier and therefore is not effective.

Question 7

Levodopa does _______________________. When levodopa is given with carbidopa more of the drug then ___________.

Answer 7

• cross the blood brain barrier, in small amounts is converted into Dopamine.
• -reaches the brain.

Question 8

carbidopa has ____ when ________.

Answer 8

no affect, given alone.

Question 9

Sine met is the combination of –

Answer 9

Levodopa/Carbidopa and is available in several combinations.

Question 10

uses of dopaminergic

Answer 10

treat s/s of parkinsonism.

Question 11

dopaminergic adverse reactions

Answer 11

usually not seen.
–Most serious w/ Levodopa: Choreiform Movements (involuntary twitching of the limbs or facial muscles) and Dystonic Movements (spasms that affect the tongue, jaw, eyes, and neck).

Question 12

levodopa contraindications

Answer 12

-patients with glaucoma, those receiving an MAOI, and during lactation. Use cautiously in patients with heart disease, asthma, emphysema, peptic ulcer disease, kidney and liver disease, and psychosis.

Question 13

anticholinergic drugs

Answer 13

• This class of drugs inhibits acetylcholine in the CNS.
• These drugs are less effective than the Dopaminergic drug classification.
• Used in adjunctive therapy for Parkinson’s Disease, also used to control drug-induced extrapyramidal disorders.

Question 14

ex of anticholinergic

Answer 14

• Benztropine mesylate (Cogentin),
• Biperiden (Akineton),
• Diphenhydramine procyclidine (Kemadrin),’
• Trihexyphenidyl (Artane).

Question 15

anticholinergic adverse reactions

Answer 15

dry mouth, blurred vision, dizziness, mild nausea, and nervousness.

Question 16

anticholinergic contraindications

Answer 16

• known hypersensitivity or those with
• glaucoma,
• pyloric or duodenal obstruction,
• peptic ulcers,
• prostatic hypertrophy,
• achalasia,
• myasthenia gravis,
• megacolon.
• older adults, due to that confusion and disorientation can occur.

Question 17

COMT inhibitors

Answer 17

• prolong the effect of levodopa by blocking an enzyme, which eliminates dopamine.
• These drugs are used in adjunct to levodopa/carbidopa.
• When given with levodopa it increases the duration of action of the levodopa.

Question 18

COMT inhibitors adverse reactions

Answer 18

• disorientation, confusion, light-headedness, dizziness, dyskinesias, hyperkinesias, nausea and vomiting, hallucinations, and fever.
• A serious and potentially fatal adverse reaction to Tolcapone (Tasmar) is liver failure.

Question 19

ex of COMT inhibitors

Answer 19

• Entacapone (Comtan)’

- Tolcapone (Tasmar)

Question 20

COMT contraindications

Answer 20

• known hypersensitivity and during pregnancy and lactation.
• Tolcapone is not to be used in patients with liver dysfunction.
• Used with caution in patients with hypertension, hypotension, and decreased kidney or liver function.
• COMT inhibitors should not be administered with any MAOI.

Question 21

Dopamine Receptor Agonists (NON-ERGOT)

Answer 21

Exact mechanism of how they act is not understood. They are thought to act directly on postsynaptic dopamine receptors of nerve cells in the brain. Mimics Dopamine.

Question 22

Ex of Dopamine Receptor Agonists (NON-ERGOT)

Answer 22

• Pramipexole (Mirapex)

- Ropinirole (Requip).

Question 23

Dopamine Receptor Agonists adverse reactions

Answer 23

• N/V
• dizziness,
• postural hypotension,
• hallucinations,
• somnolence,
• confusion,
• visual disturbances,
• abnormal involuntary movements,
• headache.

Question 24

Dopamine Receptor Agonists contraindications

Answer 24

• known hypersensitivity, severe ischemic heart disease, or peripheral vascular disease.
• Used with caution in patients with dyskinesia, orthostatic hypotension, and liver or renal impairment.
• Do not administer with other CNS depressants.

Question 25

Parkinson’s nursing assessment

Answer 25

• symptoms regarding the disorder,
• length the symptoms have been present,
• ability patient has to carry out ADL’s,
• patient’s current mental condition.

Question 26

Inform patient and patient family member not to discontinue the use of the antiparkinsonism drugs —-

Answer 26

can cause neurological problems.