PHARM-PARKINSONS DRUGS

Question 1

Parkinson Disease

Answer 1

Progressive -dopamine and antechyoline
s/s: akinesia, bradykinesia , ridgidy , tremor posual instability staggered gait , drolling (movement issues)
Wearing off phenomenon- variable response

Question 2

Dyskinesia

Answer 2

difficulty performing voluntary movements

Question 3

Dystonia

Answer 3

flaccid abnormal muscle tone leading to impaired movements

Question 4

SELECTIVE MAOI

Answer 4

breaks down catecholamines in the CNS. (decrease ancechyloine)
increase dopamine use alone or with levodopa

Question 5

DOPAMINE MODULATOR

Symmetrel

Answer 5

antiviral indirectly release dopamine’s from storage site MORE DOPAMINE blocks re uptake stays available
use early , only work when have some stored only good lasts then a year
give with dyskinesia
Side effect: dizziness insomnia and nausea
Drug interactions increased antircholenitgic effects

Question 6

Catechol ortho Methyltransferance COMT

Answer 6

can cause liver failure ( blocks COMT)

Question 7

Levodopa

Answer 7

one drug , precursor to dopamine , (dopamine wont cross blood brain barrier) does cross into brain and can then be broken down into dopamine INCREASES DOPAMINE EARLY PD patients with functional (5-10years) gi distress , hypotension and cardiac dysrhythmias

Question 8

DIRECT ACTING DOPAMINE RECEPTOR AGONISTS

Answer 8

stimulate dopamine recepors but nor dopamine will mimic that response

Question 9

Bromcriptine (Parlodel)

Answer 9

dont use with PVD patients

Question 10

Ropinirole (Requip)

Answer 10

focused on trimmer (restless leg)

Question 11

Dopamine Replacement Drug

Answer 11

presynaptic- Levodopa too much dopamine causes issues

carbidopa is given with levodopa

Question 12

Carbidopa

Answer 12

body guard for levodopa want to get in brain

Question 13

LEVODOPA CARBIDOPA THREAPY

SINEMET

Answer 13

DRY YOU OUT , LOW PROTEN DIET , ADJUNCT FOR NAUSEA , best taken on empty stomach but if have GI upset will take with other food
contradicted in angle closure glaucoma
adverse: cardiac dysthymias hypotension chorea muscle cramps
interactions: pryidosine and dietary protein

Question 14

Anticholinergic Therapy

Answer 14

DRY UP SLUDGE , sludge(salivation lacrimation urination diarrhea increased GI motility and possibly emesis
slow down gut urrinary retention dry eyes dry mouth constipation
take at night not going to have complaints of feeling dry , dont take with other medications becaue anticholergics slows GI tract

Question 15

BENTROZPINE (CONGENTIN)

diphenhydramine (BENADRYL)

Answer 15

ANTICHOLINGERIC DRUG USED FOR PD AND ANTIPSYC
S/S: CONFUSION , HYPERTHERMIA , TACHYCARDI CONFUISON URINARY RENTION DRY THROAT VOMITING
AVOID ALCHOL

Question 16

NURSING IMPLICATIONS

Answer 16

mask like expression speech may not match effect
dont mix with other drugs
when start drugs may have dizzness
administer oral doses with food a to minize GI upset
encourage fluids at least 3000 ml a day
can have HTN crisis with levodpa adn MAOI
DONT STOP SUDDENLY
MAY DARKEN THE PATIENTS URINE ADN SWEAT
COMT inhibtors may take WEEKS ,