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26 Cards in this Set
- Front
- Back
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Parkinson's disease (PD) |
Basal ganglia have decreased DA causing bradykinesia (slowed movements), rigidity, tremor at rest, impaired postural reflexes Has 3 stages |
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Other sx of PD |
jerky movements, weakness, akinesia (inability to make deliberate movements), neuro probs, pill-rolling tremor, dementia, hyperphoneia, dead pan expression, micrographia |
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PD DX |
2/3 sx of classic triad (resting tremor, rigidity, bradykinesia) Confirmation made by positive response to meds |
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PD pharm |
Only for sx relief by restoring balance between DA and Ach |
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Levadopa (L dopa) |
DA replacement therapy Effects take serveral months Avoid 1st gen antipsychotics SE: GI, CV, harmless darkening of urine/sweat, psychosis, involuntary movements, activation of malignant melanoma "Wearing off" = permanent, gradual, subtherapeutic levels To increase absorption Do not take with protein and take carbidopa (has no therapeutic effects alone) |
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Multiple sclerosis (MS) |
Unknown cause, affects young to Middle Ages, live about 25 yrs after dx Disease process=destruction of myelin by immune system, decrease in oligodendrocytes, proliferation of astrocytes, leading to plaque formations |
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MS sx |
Cognitive (memory planning, etc, not intellect), motor (tremors, weakness), sensory (parasthesia), vision (optic neuritis!), fatigue |
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MS dx |
H, sx, lesions on MRI, CSF tests |
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MS pharm |
To slow disease progression, prevent relapse, delay permanent neuro loss all with immunomodulators and immunosupprssants |
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TX foracute relapse |
Corticosteroids |
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Interferon Beta |
Immunomodulator (stimulates immune response to decrease relapses, # of lesions, delays progression) AE: flu-like sx that wear off, hepatotoxicity, myelosuppression, inj site rxn (check technique), photosensitivity |
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Glairamer acetate |
Immunomodulator Protects myelin AE: inj site rxn, post inj rxn (MI!) |
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Fingolimod |
Only PO Monitor for bradycardia 6 hrs after 1st dose Report chest pain, dysrrthmias, dizziness |
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Mitoxantrone |
Immunosuppressant Toxic Monitor CBC, LFTs, pregnancy, echo Blue/green urine is normal |
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Huntington's disease (HD) |
Increase in DA caused by an autosomal dominantinherited disease causing progressive loss of intellectual fx with personality/mood changes and increasing involuntary movements (chorea) |
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3 disorders of HD |
1. movement (chorea) 2. cognitive (decrease intellectual fx) 3. psych (depression, anxiety, suicide) |
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Other sx of HD |
Wt loss, respiratory distress, sleep deprivation, death from complications |
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Amyotrophic Lateral Sclerosis (ALS) |
Rare progressive disorder causing loss of motor neurons without known origin Pts die within 2-6yrs of dx |
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ALS sx |
Weakness, dysarthia, dysphagia, muscle wasting, COGNITION REMAINS INTACT |
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Mgmt: PD |
-Dont start L dopa until sx are bad because it can wear off (permanent) -Too much DA can cause paradoxical intoxication -Prolonged use of L dopa can cause on-off periods (stopping walking suddenly) when drug stops working |
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Mgmt: PD tx |
Surgical: ablation (less common, more destructive), deep tissue brain stimulation Nutritional: veggies to decrease constipation, 6 small meals per day, no fat/protein with meds |
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Mgmt: MS presentation |
Parasthesias, optic neuritis!, bladder rtn No cure, relieve sx |
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Mgmt: MS (be aware!) |
Body mechanics Evaluate energy
Attention (pay) Weekly plan Activities=prioritize Rest EXERCISE |
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Mgmt: MS avoids |
Extreme heat/cold Triggers Infx fatigue Tetracycline/neomycin (increased muscle weakness) |
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Mgmt: HD |
Palliative care Nutritional support (because of problems swallowing, movements, increased caloric needs) Maintain safety Tx physical sx and provide support DRUGS: Haldol, thorizaine, librium, xenzine (do not delay progression, but help with chorea) |
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Mgmt: ALS |
Decrease risk for aspiration Facilitate communication Decrease pain associated with muscle weakness distract |
