final: chronic neuro drugs

Question 1

parkinson’s is an excess of ….. and a depletion of ….

Answer 1

excess of acetylcholine

depletion of dopamine

Question 2

in order to treat parkinsons’ drugs must

Answer 2

increase dopamine

decrease acetylcholine

Question 3

parkinson’s treatment only does what with the disease

Answer 3

delay the progression

Question 4

levodopa/carbidopia (sinemet) used for

Answer 4

parkinson’s

Question 5

Levodopa/Carbidopa (Sinemet) …. levodopa becomes

Answer 5

levodopa becomes dopamine in the brain and crosses the BBB

Question 6

Levodopa/Carbidopa (Sinemet)… carbidopa does what

Answer 6

carbidopa gets the levodopa to the brain but doesnt cross the bbb

Question 7

if Levodopa/Carbidopa (Sinemet) fails, suspect

Answer 7

a misdiagnosis of parkinson’s

Question 8

SE of Levodopa/Carbidopa (Sinemet)

Answer 8

• n/v
• cardiovasccular
• hallucinations, CNS effects
• activates meanoma
• dyskinesias

Question 9

Levodopa/Carbidopa (Sinemet) drug interactions

Answer 9

• MAO-I (hypertensive crisis)
• antipsychotics (block dopamine)
• high protein foods reduce terapeutic effects

Question 10

instruct pt taking Levodopa/Carbidopa (Sinemet) to do what with meals

Answer 10

spread protein throughout the day

Question 11

pramipexole (mirapex) uses

Answer 11

used for PRA-kinsons

Question 12

pramipexole (mirapex) action

Answer 12

non-ergot dopamine agonist= direct activation of dopamine in striatum

Question 13

pramipexole (mirapex) can be used how

Answer 13

alone or as adjunct to Ldopa/Cdopa

Question 14

do not give pramipexole (mirapex) to those with impulse control disorder why

Answer 14

because it can cause SE like compulsive gambling (this is because of the direct dopamine activation_

Question 15

SE of pramipexole (mirapex) when used alone

Answer 15

• nausea, constipation
• dizziness
• sleep disturbances and hallucinations

Question 16

SE of pramipexole (mirapex) when combined with Ldopa/Cdopa

Answer 16

• orthostatic hypotension
• dyskinesias
• hallucinations

Question 17

alzheimer’s disease is a depletion of

Answer 17

acetylcholine

Question 18

to treat alzheimer’s disease, drugs must

Answer 18

increase acetylcholine

Question 19

inhibiting acetylcholinesterase stops

Answer 19

the break down of acetylcholine

Question 20

donepexil (aricept) class

Answer 20

acetylcholinesterase inhibitor

Question 21

donepexil (aricept) action

Answer 21

inhibits metabolism of acetylcholine in brain making it more available

Question 22

donepexil (aricept) does what with alzheimers

Answer 22

doesnt cure but delays progression by a little more than a year

Question 23

donepexil (aricept) use

Answer 23

used for alzheimers

Question 24

donepexil (aricept) SE

Answer 24

• n/d
• bradycardia
• fainting
• falls
• fall related fractures

Question 25

when to take donepexil (aricept)

Answer 25

at bedtime due to SE thus reducing risk of falls

Question 26

contraindications for donepexil (aricept)

Answer 26

do not combine with anticholinergic drugs including first gen antihistamines (benadryl)

Question 27

what is MS

Answer 27

neurological autoimmune disorder where the immune system eats away the myelin sheaths

Question 28

what can we do with drugs to MS

Answer 28

slowed with treatment early treatment increases the chances of significantly improving the prognosis

Question 29

Interferon Beta (Refib) class

Answer 29

immunomodulator disease modifying drug: naturally occurring cytokine

Question 30

Interferon Beta (Refib) action

Answer 30

reduces the frequency/severity of MS attacks, number and size of lesions delays progression f disability

Question 31

Interferon Beta (Refib) is given

Answer 31

injection

Question 32

Interferon Beta (Refib) SE

Answer 32

- flu like symptoms - depression and suicidal thoughts - extensive liver involvement

Question 33

Interferon Beta (Refib) nursing implications

Answer 33

obtain baseline CBC and LFT's

Question 34

what to check with Interferon Beta (Refib)

Answer 34

check liver function

Question 35

Interferon Beta (Refib) interactions

Answer 35

dont give with other drugs that affect the liver do not take with booze

Question 36

Interferon Beta (Refib) use

Answer 36

MS

Question 37

what is spasticity

Answer 37

movement disorder of CNS

Question 38

what is the most common cause of spasticity

Answer 38

MS and cerebral palsy

Question 39

characteristics of spasticity

Answer 39

- heightened muscle tone - spasm - loss of dexterity

Question 40

drugs for spasticity and what they have in common

Answer 40

- baclofen (CNS) - dantrolene (directly on muscle) - Diazepam (CNS) all have CNS depressing qualities

Question 41

Baclofen (Lioresal) MOA

Answer 41

- works in CNS | - mimics GABA in spinal (back) neurons to suppress hyper reflexes

Question 42

Baclofen (Lioresal) use

Answer 42

relief of spasticity related to cerebral palsy, spinal cord injury, and MS

Question 43

Baclofen (Lioresal) admin

Answer 43

intrathecally (in the back)

Question 44

Baclofen (Lioresal) SE

Answer 44

- nausea, - urinary retention - constipation - orthostatic hypotension

Question 45

caution with Baclofen (Lioresal)

Answer 45

dont operate machinery until you know your response to drug

Question 46

how to stop Baclofen (Lioresal)

Answer 46

gradual taper abrupt withdrawal= rhabdomyolysis

Question 47

Dantrolene (Dantrium) MOA

Answer 47

- peripherally acting muscle relaxant | - inhibits muscle contraction by preventing release of calcium in skeletal muscles

Question 48

Dantrolene (Dantrium) uses

Answer 48

- relief of spasticity due to cerebral palsy or MS | - treatment of malignant hyperthermia

Question 49

Dantrolene (Dantrium) SE

Answer 49

- CNS depression | - Hepatic tox

Question 50

Dantrolene (Dantrium) contraindications

Answer 50

- caution with impaired liver function | - CNS depressants additive effects