Q2 Flashcards
What is Parkinson’s Disease?
Chronic, progressive, degenerative disorder of the CNS
Symptoms of Parkinson’s Disease
Resting tremor
Bradykinesia
Rigidity
Postural instability
Risk Factors of Parkinson’s
Age
Genetics
Sex
Exposure to Toxins
Is there a reciprocal relationship between Dopamine and Acetylcholine?
Yes
Vasodilator
Widening of the blood vessels in the cardiovascular system, allowing blood to flow more easily
T/F - increasing acetylcholine activity by reducing dopamine increases the risk of EPS
True
Bromocriptine (Parlodel)
Effective in the urgent treatment of NMS
Dosage of Bromocriptine
1.25-40 mg
What do Dopamine Receptor Agonists do?
Increase dopamine activity in the brain
What do MAO-B Inhibitors do?
Prevent breakdown of brain dopamine by inhibiting the brain enzyme monoamine oxidase B
Benztropine is used for?
Dystonia, Parkinsonism, Akinesia, Akathisia
Benztropine dosage?
1-2 mg BID
B blockers are?
Competes to bind at adrenergic receptors and has an antagonist effect on certain serotonin receptors
Used to reduce symptoms of Tardive Dyskinesia
Reduce blood pressure
Example of a beta blocker
Propranolol
Dosage of Propranolol
60-120 mg
Antiparkinsonian Medications are absorbed where?
GI Tract
Antiparkinsonian - Distribution
Throughout the body
Antiparkinsonian - Metabolism
Liver
Antiparkinsonian - Excretion
Urine and bile
Cross the placenta and enter breast milk
What should be used to monitor side effects while on antipsychotic medication?
AIMS
EMERGENCY - Antiparkinsonian
Dystonic Reactions (benztropine - oculogyric crisis, torticollis, opisthotonos)
NMS (bromocriptine - discontinue)
DiphenhyDRAMINE
Benadryl
DimenhyDRINATE
Gravol
Common Side Effects of Antiparkinsonian Drugs - Autonomic
Dry mouth
Blurred vision
Constipation
Stomach irritation
Tachycardia
Urinary retention
Paralytic ileus
Common Side Effects - Antiparkinsonian - Behavioural
Confusion
Giddiness
Listlessness
Depression
Visual Hallucinations
Side effects of Propranolol
Congestive Heart Failure, Decreased Libido, Raynaud’s syndrome
Side effect of Benadryl
Sedation
Amantadine
Orthostatic hypotension, livido reticularis (purple mottling to the skin), abnormal dreams
Biperiden
Fewer Ach effects, but can cause euphoria and increased tremor
Anticholinergic Withdrawal Symptoms
Nausea
Vomiting
Dyskinesia
Restlessness
Sweating
Anxiety
Depression
Anticholinergic Crisis
Dilated pupils
Increased thirst
Urinary retention
Paralytic ileus
Tachycardia
“hot as a hare, blind as a bat, mad as a hatter, dry as a bone”
Drug Interactions - Dopamine Receptor Agonists
Cholinesterase inhibitors
- used to slow the symptom progression of Alzheimer’s - combination will produce an antagonistic action
Specifications of Benadryl
Drug of choice for children over the age of 6 and more than 9 kg
Monoamine Neurotransmitter Dysfunction
Deficiency of norepinephrine and/or serotonin
What are three biogenic amines?
Norepinephrine
Dopamine
Serotonin
What is monoamine oxidase?
Enzymes that catalyzes the breakdown of monoamines such as serotonin, dopamine and norepinephrine
Treatment of Depressive Disorders
First Generation - tricyclic antidepressants, monoamine oxidase inhibitors
Second Generation - selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors, atypical antidepressants