Parkinsons

timing

A later adverse effect of levodopa treatment is on-off phenomenon, which reflects the ________________ of drug administration. If the client does not receive doses on time, this will increase the amount of negative symptoms experienced

orthostatic hypotension, falls

Adverse effects of dopaminergic drugs such as carbidopa-levodopa include _______________________. The dizziness and potential for fainting associated with this effect can increase the risk of _____________.

dry mouth

Anticholinergic drugs may cause blurred vision, ___________________, tachycardia, and urinary retention

myasthenia gravis

Anticholinergics are contraindicated for clients with ____________________, which could be exacerbated by the blocking of acetylcholine receptor sites at the neuromuscular synapses.

hypotension

Apomorphine is associated with a risk for ________________ and a prolonged QT interval. Therefore, the priority would be to monitor the client's cardiac status closely.

antidepressants

Carbidopa-levodopa can interact substantially with hydantoins, MAOIs, phenothiazines, or tricyclic ___________________

- dry mouth - urinary retention - constipation - increased pulse rate

Common side effects of anticholinergics include: ..........

observation

Drugs administered for Parkinsonism may cause a wide variety of adverse effects, which requires careful __________________ of the client.

COMT

Entacapone and tolcapone are classified as ___________ inhibitors.

levodopa

Generally, a single drug called _____________________ is administered to clients with Parkinson's disease.

dopamine release

Lack of _________________ is the primary cause of Parkinson disease and associated symptoms.

replacement

Levodopa is a precursor of dopamine that crosses the blood-brain barrier, where it is converted to dopamine, acting like a ________________ therapy.

levodopa

Many multivitamins contain vitamin B_, which is contraindicated during the use of _____________

dyskinesia

Most clients within 5 to 10 years of taking levodopa develop a response to the medication called _____________________, manifested as facial grimacing, rhythmic jerking movements of the hands, head bobbing, chewing and smacking movements, and involuntary movements of the trunk and extremities.

transdermal patch

Rotigotine is administered solely by ___________________, not by intravenous or subcutaneous routes.

glaucoma

Since levodopa can dilate pupils and raise intraocular pressure, it is contraindicated in narrow-angle _________________

lower

Sinemet allows the client to benefit from levodopa while taking a ___________ dose.

tremor, bradykinesia

The cardinal manifestations of Parkinson disease are __________, rigidity, and _______________ (slowness of movement)

rigidity

The cardinal manifestations of Parkinson disease are tremor, ______________, and bradykinesia (slowness of movement)

- tremor - rigidity (hypertonicity) - bradykinesia - slowness of movement

The cardinal symptoms of Parkinson disease (PD) are: ...........

meperidine

The dopamine agonists, which are monoamine oxidase inhibitors, selegiline and rasagiline should not be administered with ________________ as the combination increases the risk of serotonin syndrome.

confusion, disorientation

The nurse should assess for _________________ and ________________ when caring for the elderly patient undergoing anticholinergic drug therapy. Individuals older than 60 years frequently develop increased sensitivity to anticholinergic drugs and require careful monitoring

lowest

The optimal dose is the ____________ one that allows the client to function adequately.

dopamine

The primary brain abnormality found in all persons diagnosed with Parkinson disease is degeneration of the nigrostriatal ___________________ neurons.

liver

Tolcapone therapy should not be initiated for any person with __________ disease or elevated liver enzymes.

Huntington disease

Which disease is a chronic, progressive, hereditary disease of the nervous system that results in progressive, involuntary dancelike movements and dementia?

Levodopa, carbidopa

______________ restores dopamine, and ___________________ decreases peripheral breakdown of levodopa.

Carbidopa

_______________ (Lodosyn) is classified as a dopaminergic agent that treats parkinsonism by supplementing the amount of dopamine in the bra

Rasagiline

_________________ has the potential to increase serotonin neurotransmission. When given with other drugs that enhance stimulation of serotonergic receptors (e.g., antidepressants, St. John's wort, dextromethorphan, and meperidine), serotonin syndrome, a potential fatal CNS toxicity reaction characterized by hyperpyrexia and death, can occur.

Blurred vision

_________________ is considered a peripheral anticholinergic effect.

Huntington

__________________ disease is a hereditary disorder which produces localized death of brain cells.

Choreiform

__________________ movements, suicidal tendencies, and psychotic episodes are serious adverse reactions associated with the use of levodopa, which is a dopaminergic drug.

Myasthenia gravis

____________________ is an autoimmune disease caused by antibody-mediated loss of acetylcholine receptors in the neuromuscular junction.

Bradykinesia

____________________ is characterized by slowness in initiating and performing movements and difficulty in sudden, unexpected stopping of voluntary movements.