Parkinson's Disease Flashcards
Parkinsons Disease
Brain disorder that causes unintended/uncontrollable movements; shaking, stiffness, balance & coordination
Gradual start; worsens overtime=> difficulty walking & talking
Mwntal & behavioral changes, sleep problems, depression, memory difficulties & fatigue
Parkinsons Disease
RISK & CAUSES
Risk: >60y.o. ; Men > Women; some inherited; gene mutation
Causes: PAR
Primary neuronal degeneration (75%)
After encephalitis or antidopaminergics (chlorpromazine, haloperidol, metoclopamine)
Rare causes such as WIlsons disesase or toxins
PD Symptoms & Goal
PAR: Paucity of movements, Abnormal tremors, movements & posture, Rigidity
Other symptoms: depression & other emotional changes, difficulty swallowing, cheweing, speaking, urinary problems or constipation, skin problems
GOAL: increase dopamine in the brain, affect on other NT; which transfers info between cells, help control non-movements symptoms
Dopaminergic Agents
* Levodopa/Carbidopa
* Dopamine Agonist
SE: dyskinesia; dystonia (12-17%) , Nausea (6%)
ADR: NMS; high fever, confusion, irregualr pulse, sweating , **muscle stiffness **, change in BP
Education: Take multiple times a day to control symptoms. Can make you sleepy & fall asleep suddenly. Can darken color of saliva, sweat, & urine. MIght not work as well if P.D symptoms worsen
Levodopa/ Carbidopa
MOA
MOA: increase dopamine levels in the brain
Levodopa: dopamine replacement. Travels into the brain => converted to dopamine. Relieves P.D. symptoms by restoryng dopamine in the brain.
**Carbidopa: **dopa decarboxylase inhibitor. A protein in your body tht breaks down levodopa before it can travel into your body.
Dopamine Agonist
* Amantadine
* Pramipexole
SE: sleepiness, fainting , impulsivity, compulsiveness, hallucinations & delusion
ADR: dopamine agonist withdrawal syndrome (anxiety/panic attacks, diaphoresis, agitation)
Education: support groups can help people cope.
NEVER stop taking levodopa w/o doctor.
SERIOUS SE: unable to move or having difficulty breathing
Myasthenia Gravis
(2) stigmine
Indication: MG
MOA: Inhibits acetylcholinesterase
SE: cholinergic effects; miosis, blurred vision, headache, dizziness
MG Education
Purpose of med: improve muscle strenght, decrease fatigue
* Take TID on an empty stomach & on a regular schedule
* Keep record of sx before & after med; notify HCP if sx DONT improve or get worse
* Recognize sx of excessive Cholinergic Effects/Crisis & of Myasthenic Crisis - seek medical attention immediately
* wear medic alert identification @ all times
ALzheimers
Acetylcholinesterase Inhibitors
2 (mine) 1 (zil)
Rivastigmine (Exelon), Galantamine (Razantime), Donepezil (Aricept)
MOA: inhibit acetylcholinesterase
SE: Miosis, blurred vision, headache, dizziness, drowsiness urengy to urinate
C.I: severe hepatic or kidney disease
Education: take w/ food to decrease GI upset, Postural Hypotension
