Parkinsons disease and ALS Flashcards
main neurotransmitter that is affected in parkinsons
dopamine
extrapyramidal tracts
part of the brain controls semiautomatic functions and coordinated movmt
level of dopamine in parkinsons
down to 80%
resting tremors
tremors disappear with movement and sleeping
rigidity
resistance to passive limb movement
passive movement of the extremity
causes limb to move in jerky in increments called cogwheel rigidity
shuffling gait (postural instability)
pt tries to walk faster trying to move feet forward under center of gravity - steps are shorter in stride and drag their feet and reduce arm movement
freezing gait (postural instability)
difficultly in initiating walking – feet are glued to the floor
psychiatric changes in parkinsons patients
depression, anxiety, dementia, delirium, hallucination
hypokinesia
decresed range of bodily mvmt/slow
dysphonia
voice impairment– voice is hoarse/nasal
levodopa “on-off syndrome”
sudden periods of immobility (seems like drug is not working/then working again)
dyskinesia
involuntary repetitive of facial and oral muscles
Anticholingeric drug info
-Trihexyphenidyl hydrochloride- control tremors
-Benztropine mesylate- counteract the action of the acetylcholine
SE: constipation, urinary retention, blurred vision; CI: patient with narrow angle glaucoma
amantidine hydrochloride
antiviral
reduces rigidity and tremor, bradykinesia in early parkinsons
se: hallucination; depression
Bromocriptine mesylate (dopamine agonist)
secondary drug used after levodopa losses its effectiveness
SE hypotension, lightheadedness
Ropinirole hydrochloride
Nonergot derivative
SE: dizziness, drowsiness
what to do if patient has SE like insomnia, hallucination etc. ?
stop drug see if it subsides, if it doesn’t then it’s the disease not the drug
pudding-thick
spoon-thick, holds own shape, requires a spoon (advanced parkinsons - those who can not swallow)
risk factors for amyoptripic later sclerosis/ Lou Gehrig disease
smoking; viral infections; autoimmune disease; environmental exposure to toxins
when/how does Lou Gehrig disease occur
Commonly occurs between 40-60 years of age; affects all social and racial background; men affected slightly more than women;
About 5-10% of cases are familial from an autosomal dominant trait
diagnosis for Lou Gehrig disease
based ONLY on s/s - no labs specific
Riluzole (Rilutek)- glutamate antagonist
– can prolong the survival ; Neuroprotective effect especially in early stage
