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29 Cards in this Set
- Front
- Back
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Parkinson disease is the degeneration of?
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dopamine producing neurons in the midbrain
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It is an imbalance of what? how are they imbalanced?
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- Dopamine and acetylcholine
- low dopamine and high acetycholine |
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What is dopamine needed for?
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Normal functioning of extrapyramidal motor function: posture, support, voluntary motion
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Symptoms do not occur until what percentage of neurons are lost?
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80%
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At what age do you see symptoms?
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40-70
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Are the s/s gradual or fast?
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Gradual
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What are the 4 main s/s that characterize Parkinson's?
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- Bradykinesia
- Increased muscle tone (rigidity) - Tremor at rest - Impaired postural reflexes |
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What is usually the first s/s?
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Tremor
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What is bradykinesia? examples
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- Slowing down in initiation and execution of movement
- masked facies, shuffling gait, drooling |
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How is it positively dx?
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Must have 2 out of the 3 s/s and positive response to anti-parkinsonism drugs
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What are some common complications?
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Dysphagia
Pneumonia, UTI, skin breakdown Gait issues, constipation Orthostatic hypotension Depression, anxiety, apathy, pain, dementia, sleep disorders |
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What three types of drugs are given?
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- Dopamine agonists
- Anticholinergics - Antihistamine |
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What do dopamine agonists do? examples?
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- Enhances release or supply of dopamine, relieve bradykinesia, tremor, rigidity
- Requip, Mirapex, Sinemet, Apokyn |
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What is the initial dopamine agonists given to someone with severe s/s? What does it cause long term?
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- Sinemet
- Dyskinesia |
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What should you watch for with dopamine agonists drugs?
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- EPS symptoms: hypotension, agitation, confusion
- Orthostatic hypotension - Hallucinations - Sleepiness/ drowsiness |
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What do anticholinergics do? examples?
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- Antagonize or block the effects of overactive cholinergic nuerons, relieve tremors
- Artane, Cogentin, Akineton |
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What should you watch for with anticholinergics?
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- Dry mouth
- Urinary retention - Constipation - Delirium - Agitation - Hallucinations |
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What do antihistamines do? example?
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- Relieve tremor, rigidity
- Benadryl |
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What should you watch for when giving antihistamines?
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- Anticholinergic effects
- Sedation |
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Should you give Benadryl to the elderly? why or why not?
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- No, b/c they become very sedated
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Monoamine Oxidase Inhibitors are similar to what drug type? What should be avoided when taking these?
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- Dopaminergic
- Avoid tyramine to prevent severe hypertension |
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True or False
Patients are usually put on anticholinergic and antihistamine first then dopaminergic. |
True
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s/s of drug toxicity?
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- Delirium
- Cognitive impairment - Hallucinations |
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If a patient is showing drug toxicity or drug tolerance what should you do?
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- Reduction in drug dosage
- Change in drug or in frequency - Drug holiday |
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When is surgical therapy used on Parkinson patients?
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When they are unresponsive to drug therapy
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What are the surgical procedures used?
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- Stereotactic pallidotomy
- Thalamotomy - Deep brain stimulation - Fetal transplantation |
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What would you teach the patient about levodopa overdose?
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- Freezing when walking
- Dyskinesia with athetosis of neck |
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What will you teach the parkinson's patient about day to day activities?
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- Promote physical exercise
- Well balanced diet - Rock side to side for balance - Lift toes when stepping - Use upright chair with arms and place blocks on legs |
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What are safety teaching for the parkinson's patient?
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- Remove excess rugs and furniture
- Use slip on shoes and velcro fasteners |
