NEURO - parkinson's (PD) medications

Question 1

exemplar drug for dopamine replacement drugs

Answer 1

LEVODOPA/CARBIDOPA

Question 2

route of LEVODOPA/CARBIDOPA

Answer 2

PO

Question 3

uses of LEVODOPA/CARBIDOPA

Answer 3

designed to cross the BBB where they be taken up by substantia nigra and converted to dopamine

Question 4

pharmacologic action of LEVODOPA/CARBIDOPA

Answer 4

• LEVODOPA = dopamine precursor
• CARBIDOPA protects LEVO from being converted to dopamine outside of CNS –> more can cross the BB B –> be used to increase dopamine production in the CNS

Question 5

adverse reactions of LEVO/CARBI

Answer 5

• n/v
• orthostatic hypotension
• darkened sweat & urine
• increased dyskinesia (at the beginning of treatment)

Question 6

nursing intervention of LEVO/CARBI

Answer 6

monitor for dyskinesia & orthostatic hypotension

Question 7

client education of LEVO/CARBI

Answer 7

• start with a low dose & then increase
• takes up to 6 months to achieve therapeutic dose
• take with foods, but NO high protein foods

Question 8

interactions with LEVO/CARBI

Answer 8

• first gen antipsychotics decrease absorption
• anticholinergic drugs increase response
• MAOIs can cause hypertensive crisis

Question 9

exemplar drug for direct-acting dopamine receptor agonist

Answer 9

PRAMIPEXOLE

Question 10

route for PRAMIPEXOLE

Answer 10

PO

Question 11

uses of PRAMIPEXOLE

Answer 11

decrease parkinson-related symptoms

Question 12

pharmacologic action of PRAMIPEXOLE

Answer 12

binds to dopamine receptors –> mimics actions of dopamine in body

Question 13

adverse reactions of PRAMIPEXOLE

Answer 13

• nausea
• orthostatic hypotension
• dyskinesia
• drowsiness

Question 14

nursing interventions of PRAMIPEXOLE

Answer 14

• give with food to decrease GI issues
• monitor for drowsiness & orthostatic hypotension

Question 15

client education of PRAMIPEXOLE

Answer 15

• start with low dose & titrate up to desired effect
• take with food IF experiencing nausea
• move slowly while changing positions
• taper doses if discontinuing

Question 16

interactions with PRAMIPEXOLE

Answer 16

• CIMETIDINE increases amounts of PRAMIPEXOLE
• METOCLOPRAMIDE decreases effects of drug
• first gen antipsychotics decreases effects of drug

Question 17

exemplar drug of MAO-B inhibitors

Answer 17

SELEGILINE

Question 18

route of SELEGILINE

Answer 18

PO

Question 19

uses of SELEGILINE

Answer 19

• reduce parkinson symptoms
• usually used with LEVO/CARBI

Question 20

pharmacologic action of SELEGILINE

Answer 20

decreases amount of MAO-B in body (it inactivates dopamine) –> amount of dopamine is effectively increased

Question 21

adverse reactions of SELEGILINE

Answer 21

• insomnia
• hypertensive crisis in high doses

Question 22

nursing interventions of SELEGILINE

Answer 22

monitor for insomnia & hypertension

Question 23

client education of SELEGILINE

Answer 23

• take before noon to minimize insomnia
• report changes in oral mucosa to provider
• report any new drugs to avoid hypertensive crisis

Question 24

interactions with SELEGILINE

Answer 24

• MEPERIDINE, MAORs, TCAs & SSRIs: cause fever & muscle rigidity in conjunction with SELEGILINE
• antihypertensive drugs: severe hypotension