final: chronic neuro drugs Flashcards by sarah beeney

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

excess of acetylcholine

depletion of dopamine

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in order to treat parkinsons’ drugs must

increase dopamine

decrease acetylcholine

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parkinson’s treatment only does what with the disease

delay the progression

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levodopa/carbidopia (sinemet) used for

parkinson’s

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Levodopa/Carbidopa (Sinemet) …. levodopa becomes

levodopa becomes dopamine in the brain and crosses the BBB

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Levodopa/Carbidopa (Sinemet)… carbidopa does what

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

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if Levodopa/Carbidopa (Sinemet) fails, suspect

a misdiagnosis of parkinson’s

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SE of Levodopa/Carbidopa (Sinemet)

n/v
cardiovasccular
hallucinations, CNS effects
activates meanoma
dyskinesias

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Levodopa/Carbidopa (Sinemet) drug interactions

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

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

spread protein throughout the day

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pramipexole (mirapex) uses

used for PRA-kinsons

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pramipexole (mirapex) action

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

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pramipexole (mirapex) can be used how

alone or as adjunct to Ldopa/Cdopa

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

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

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SE of pramipexole (mirapex) when used alone

nausea, constipation
dizziness
sleep disturbances and hallucinations

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

orthostatic hypotension
dyskinesias
hallucinations

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alzheimer’s disease is a depletion of

acetylcholine

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to treat alzheimer’s disease, drugs must

increase acetylcholine

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inhibiting acetylcholinesterase stops

the break down of acetylcholine

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donepexil (aricept) class

acetylcholinesterase inhibitor

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donepexil (aricept) action

inhibits metabolism of acetylcholine in brain making it more available

donepexil (aricept) does what with alzheimers

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

donepexil (aricept) use

used for alzheimers

donepexil (aricept) SE

n/d
bradycardia
fainting
falls
fall related fractures

when to take donepexil (aricept)

at bedtime due to SE thus reducing risk of falls

contraindications for donepexil (aricept)

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

what is MS

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

what can we do with drugs to MS

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

Interferon Beta (Refib) class

immunomodulator disease modifying drug: naturally occurring cytokine

Interferon Beta (Refib) action

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

Interferon Beta (Refib) is given

injection

Interferon Beta (Refib) SE

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

Interferon Beta (Refib) nursing implications

obtain baseline CBC and LFT's

what to check with Interferon Beta (Refib)

check liver function

Interferon Beta (Refib) interactions

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

Interferon Beta (Refib) use

what is spasticity

movement disorder of CNS

what is the most common cause of spasticity

MS and cerebral palsy

characteristics of spasticity

- heightened muscle tone - spasm - loss of dexterity

drugs for spasticity and what they have in common

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

Baclofen (Lioresal) MOA

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

Baclofen (Lioresal) use

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

Baclofen (Lioresal) admin

intrathecally (in the back)

Baclofen (Lioresal) SE

- nausea, - urinary retention - constipation - orthostatic hypotension

caution with Baclofen (Lioresal)

dont operate machinery until you know your response to drug

how to stop Baclofen (Lioresal)

gradual taper abrupt withdrawal= rhabdomyolysis

Dantrolene (Dantrium) MOA

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

Dantrolene (Dantrium) uses

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

Dantrolene (Dantrium) SE

- CNS depression | - Hepatic tox

Dantrolene (Dantrium) contraindications

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