NEURO - parkinson's (PD) medications Flashcards
exemplar drug for dopamine replacement drugs
LEVODOPA/CARBIDOPA
route of LEVODOPA/CARBIDOPA
PO
uses of LEVODOPA/CARBIDOPA
designed to cross the BBB where they be taken up by substantia nigra and converted to dopamine
pharmacologic action of LEVODOPA/CARBIDOPA
- 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
adverse reactions of LEVO/CARBI
- n/v
- orthostatic hypotension
- darkened sweat & urine
- increased dyskinesia (at the beginning of treatment)
nursing intervention of LEVO/CARBI
monitor for dyskinesia & orthostatic hypotension
client education of LEVO/CARBI
- start with a low dose & then increase
- takes up to 6 months to achieve therapeutic dose
- take with foods, but NO high protein foods
interactions with LEVO/CARBI
- first gen antipsychotics decrease absorption
- anticholinergic drugs increase response
- MAOIs can cause hypertensive crisis
exemplar drug for direct-acting dopamine receptor agonist
PRAMIPEXOLE
route for PRAMIPEXOLE
PO
uses of PRAMIPEXOLE
decrease parkinson-related symptoms
pharmacologic action of PRAMIPEXOLE
binds to dopamine receptors –> mimics actions of dopamine in body
adverse reactions of PRAMIPEXOLE
- nausea
- orthostatic hypotension
- dyskinesia
- drowsiness
nursing interventions of PRAMIPEXOLE
- give with food to decrease GI issues
- monitor for drowsiness & orthostatic hypotension
client education of PRAMIPEXOLE
- start with low dose & titrate up to desired effect
- take with food IF experiencing nausea
- move slowly while changing positions
- taper doses if discontinuing
interactions with PRAMIPEXOLE
- CIMETIDINE increases amounts of PRAMIPEXOLE
- METOCLOPRAMIDE decreases effects of drug
- first gen antipsychotics decreases effects of drug
exemplar drug of MAO-B inhibitors
SELEGILINE
route of SELEGILINE
PO
uses of SELEGILINE
- reduce parkinson symptoms
- usually used with LEVO/CARBI
pharmacologic action of SELEGILINE
decreases amount of MAO-B in body (it inactivates dopamine) –> amount of dopamine is effectively increased
adverse reactions of SELEGILINE
- insomnia
- hypertensive crisis in high doses
nursing interventions of SELEGILINE
monitor for insomnia & hypertension
client education of SELEGILINE
- take before noon to minimize insomnia
- report changes in oral mucosa to provider
- report any new drugs to avoid hypertensive crisis
interactions with SELEGILINE
- MEPERIDINE, MAORs, TCAs & SSRIs: cause fever & muscle rigidity in conjunction with SELEGILINE
- antihypertensive drugs: severe hypotension
