CHAPTER 14: Drugs Used for Parkinson's Disease
How is carbidopa used for the treatment of Parkinson's disease
2) in conjunction with levodopa to reduce the dose of levodopa 3) to slow disease progression 4) in conjunction with levodopa to increase plasma levels of levodopa
Drugs classified as anti cholinergic agents are used to treat symptoms of Parkinson's disease because they
3) Decrease the amount of acetylcholine available
What is the primary purpose of selegiline (Eldepryl) therapy during the early treatment of Parkinson's disease
3) Slowing symptoms progression and delaying the initiation of levodopa
Possible adverse effects of carbidopa-levodopa therapy for a patient with Parkinson's disease include
3) orthostatic hypotension 4) involuntary movements such as chewing and bobbing 5) depression
Generally, Pt's with Parkinson's disease will be treated with carbidopa-levodopa, but the drugs effect gradually wears off in?
3-5 years
Which statement does the nurse include when teaching a Pt with Parkinson's disease about the drug apomorphine (apokyn)?
It is chemically related to morphine, but does not have any opioid activity
Rasagiline
Monoamine oxidase inhibitors type B
Selegiline
Monoamine oxidase inhibitors type B
Apomorphine
Nonergot dopamine agonists
Pramlintide
Nonergot dopamine agonists
The drug carbidopa-levodopa (simenet) must be given in combination because?
carbidopa has no effect when used alone
When patients start on monoamine oxidase type B inhibitor therapy in conjunction with carbidopa-levodopa(Sinemet), the dosages of Sinemet can be titrated downward starting at?
day 2 or 3 of therapy
Parkinson's disease is caused by a deterioration of the ?
dopaminergic neurons
This classification of drugs used to treat parkinsonism by reducing the metabolism of dopamine in the brain is?
monamine oxidase type B inhibitors
When the drugs used for Parkinson's disease start to become ineffective, it is known as?
on-off phenomenon
Active metabolites of selegiline, when swallowed, are amphetamines that cause cardiovascular and psychiatric adverse effects. To avoid this effect , the drug is administered as?
orally disintegrating tablet
The main reason anticholinergic agents are prescribed for pt's with Parkinsonism is to?
reduce hyper stimulation caused by the excess amount of acetylcholine
The major action of the drug carbidopa-levodopa (simenet) is to?
reduce metabolism of levodopa
The major action of the drug entacapone (comtan) which is a COMT inhibitor, is to?
reduce the destruction of dopamine in the peripheral tissues
The major action of the drug, rasagiline is considered neuroprotective, which ?
slows the rate of deterioration of the dopamine neurons
The therapeutic outcomes desired when an anticholinergic agent is prescribed for a Parkinson's pt include ?
1. reduced drooling 2. reduced tremors
The goal of treatment for Parkinson's disease is to?
1. moderate the symptoms of the disease 2. slow the progression of the disease
Entacapone
COMT inhibitors
Although parkinson's is considered a disease that effects the patient's ability to walk, it also has non-motor symptoms such as ?
1. orthostatic hypotension 2. nocturnal sleep disturbances 3. daytime somnolence
The drug apomorphine (Apokyn) is chemically related to morphine but does not work the same, it stimulates this in the brain instead
1) Dopamine receptors
The neurotransmitters responsible for Parkinson's symptoms are
1) Excess acetylcholine and deficient amounts of dopamine
Identify the signs and symptoms of Parkinson's disease. difficulty walking ,possibly stooped posture
1) muscle tremors 2) muscle weakness with rigidity 3) posture and equilibrium changes 4)slowness of movement in performing daily activities
A patient is suspected of having early Parkinson's disease because he is developed the following
1) weakness and tremors 2) drooling 4) slowing of normal body movement 5) depression
Which are nursing considerations for patients on apomorphine (apokyn) therapy?
1. assess pt's on apomorphine therapy for orthostatic hypotension 2. do not administer apomorphine intravenously 3. asses pt's receiving apomorphine therapy for sudden sleep attacks
Long-term use of levodopa can cause abnormal movements such as?
1. chewing motions 2. rocking 3. head and neck bobbing 4. facial grimacing
The symptoms that are targeted for treatment when anticholinergic agents are used include?
1. drooling 2. tremors
Anticholinergic agents produce which effects?
1. dry mouth 2. dry nose 3. constipation
After being treated for Parkinson's disease, pt's will demonstrate improvement in their symptoms by?
1. improved gait 2. improved speech 3. decreased tremors
What can be a cause of secondary parkinsonism?
1. intracranial infections 2. head trauma 3. tumors
The neurotransmitter that is considered to be in excess in Parkinson's disease is?
Acetylcholine
Which agents are used in the treatment of parkinson's disease primarily because they provide symptomatic relief from excessive acetylcholine?
Anticholinergic agents
The symptom of parkinson's disease manifested as extremely slow body movements that may eventually progress to a total lack of movement is known as ?
Bradykinesia
With parkinson's disease, which neurotransmitter is deficient?
Dopamine
Carbidopa
Dopamine agonists
Which medication used in treating pt's with Parkinson's disease reduces the destruction of dopamine in the peripheral tissues, allowing significantly more dopamine to reach the brain to eliminate the symptoms of parkinsonism?
Entacapone (Comtan)
