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Pharm Test 3 > Parkinsons & Dementia (week 11) > Flashcards

Parkinsons & Dementia (week 11) Flashcards

1
Q

A slowly progressive neurodegenerative disorder that affects more than 1 million Americans with symptoms of tremors, rigidity, postural instability, and slowed movement.

A

Parkinson’s Disease

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2
Q

With Parkinson’s, you have too little ____ and too much ____.

A

Dopamine

Acetylcholine

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3
Q

What does Parkinson’s medication provide?

A

Symptomatic relief, does not delay progression

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4
Q

What are the two types of drugs to treat Parkinsons?

A

Dopaminergic agents

Anticholinergic agents

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5
Q

What are the 5 Dopaminergic agents for Parkinsons?

A 
Levodopa/Carbidopa
Pramipexole
Entacapone
Selegiline
Amantadine
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6
Q

What is the MOA of Levodopa?

A

Can cross the BBB

Converted into Dopamine after it closes the BBB

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7
Q

What are the two Motor fluctuations with Levodopa?

A

Long term use leads to dyskinesias

‘Off-times’ lead to loss of symptom relief

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8
Q

What is the MOA or Carbidopa?

A

Prevents conversion of levodopa in the intestines

Strictly a carrier drug

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9
Q

Name two Dopamine replacements

A

Levodopa/Carbidopa

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10
Q

What are some side effects of Levodopa/Carbidopa?

A 
Psychosis
Dyskinesia 
N/V
Postural Hypotension
Dysrhythmias
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11
Q

What is an alternate name for Levodopa/Carbidopa?

A

Sinamet

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12
Q

What do you want to know in the MAR before administering Levodopa/Carbidopa?

A

MAOI

Anticholinergic drugs

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13
Q

What kind of meals should be avoided with Levodopa/Carbidopa?

A

High-protein meals

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14
Q

What harmless effect can levodopa/carbidopa cause?

A

Some people experience darkened urine and sweat

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15
Q

Name a Dopamine Receptor Agonist

A

Pramipexole (Mirapex)

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16
Q

What is a first line drug used for PD that is used in conjunction with Levodopa/Carbidopa to allow for lower doses?

A

Pramipexale )Mirapex)

17
Q

What is the MOA of Pramipexole (Mirapex)?

A

Direct activation of dopamine receptors in the striatum

18
Q

What are the adverse effects of Pramipexole? (Mirapex)?

A

Nausea/Dyskinesia/Postural hypotension
Hallucinations
Sleep Attacks
Impulse control disorders

19
Q

What are some nursing implications you should know with Pramipexole (Mirapex)?

A

Cautious use in older adults

May be taken with food to reduce nausea and vomiting

20
Q

What are the three other Anti-parkinsons Medications?

A

Entacapone
Amantadine
Selegiline

21
Q

Name a COMT Inhibitor

A

Entacapone

22
Q

What is the MOA of Entacapone?

A

Inhibiting COMT prevents early breakdown of Levodopa

23
Q

What is the MOA of Amantadine?

A

Promotes release of DA from remaining DA Neurons

24
Q

What drug is the only drug recommended for dyskinesias?

A

Amantadine

25
Q

Name an MAO-B inhibitor

A

Selegiline

26
Q

What is the MOA of Selegiline?

A

Prevents dopamine breakdown

27
Q

What drug is the 1st line of defense to decrease ‘off-times’ effect?

A

Selegiline

28
Q

What disease does not have enough acetylcholine?

A

Dementia

Alzheimer’s

29
Q

Treatment of _______ with these drugs can yield improvement that is statistically significant but clinically marginal

A

Alzheimer’s

30
Q

What are the four drugs approved for Alzheimers?

A

Memantine (Nemanda)
Donepezil (Aricept)
Galantamine (Razadyne)
Rivastigmine (Exelon)

31
Q

Name a Cholinesterase Inhibitor

A

Donepezil (aricept)

32
Q

What is the MOA of Donepezil (Aricept)?

A

Prevents the breakdown of Acetylcholine by (AChE) and increases the availability if acetylcholine

33
Q

What are some side effects of Donepezil (Aricept)?

A

Nausea and diarrhea
weight loss
Prolonged QT Interval
BRADYCARDIA

34
Q

What are some nursing implications you want to know with Donepezil (Aricept)?

A

Cautious use in patients with asthma or COPD
Urinary retention or obstruction
May be taken with food

Symptoms typically get better over time

35
Q

Name an NMDA Receptor

A

Memantine (Namenda)

36
Q

What is the MOA of Memantine (Namenda)?

A

Creates blockade of further calcium entry

Pharm Test 3 (15 decks)

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