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22 Cards in this Set
- Front
- Back
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What does TRAP stand for?
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T: tremor
R: rigidity A: Akinesia P: Postural instability |
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What are 4 drug therapy approaches for treating Parkinson's?
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1. Increase dopamine concentration via synthesis (precursors)
2. Replace dopamine 3. Decreasing the breakdown of dopamine via inhibiting the metabolism of Ddopamine. 4. Adjunctive anticholinergic drugs, additional drugs (agonists?) |
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What is the underlying biochemical model used with drug treatment?
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A decrease in dopaminergic activity accompanied by an increase in cholinergic activity.
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What is the goal of drug therapy when treating Parkinson's?
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Increase QOL.
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Name four drugs used to treat Parkinson's.
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1. Levodopa
2. Bromocriptine 3. MOA 4. Anticholinergic drugs |
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What is Levodopa?
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Metabolic precursor of DA. Levodopa gets converted into DA via enzyme. Restores DA levels in substantia nigra.
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What is Levodopa's MOA?
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Levodopa is readily transported into the CNS and is converted to DA. DA itself does not cross the blood-brain barrier.
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What are pharmacological actions of Levodopa?
-How is it active? -How should it be taken? -1/2 life? |
Decreases rigidity, tremors and other Sx.
-Active orally -Taken on an empty stomach, about 45 minutes after a meal. -Short 1/2 life (1-2 hours). Sustained release, but may produce on-off phenomenon. |
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What are some SE of Levodopa?
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Main SE are:
1. Peripheral effects-anorexia, nausea, and vomiting due to stimulation of emetic center. 2. CNS effects: depression, anxiety, confusion, hallucinations if given too much DA. Other SE: Tachycardia, cardiac arrhythmias, hypertension -Abnormal involuntary movements -Tolerance w/ prolonged therapy |
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What drug is Levodopa commonly combined with?
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Carbidopa. The two together are a very effective drug for Parkinson's.
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What is the MOA of Carbidopa?
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Inhibits the metabolism of Levodopa in GI tract and peripheral tissues leading to an increased availability of Levodopa in the brain.
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What is the most difficult SE associated with Levodopa and Carbidopa?
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Difficulty tolerating the GI SE, especially the nausea.
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Bromocriptine is a DA......
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DA receptor AGONIST
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How is Bromocriptine different than Levodopa?
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SE are similar except hallucinations, confusion, delirium, nausea and orthostatic hypotension are much more common. Dyskinesia is less common.
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What is the major MOI drug for Parkinsons?
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selegiline, ELDEPRYL
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How does MOI work?
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Inhibits enzyme that metabolizes dopamine, therby increasing the levels of DA in the brain. Enhances the effect of Levodopa, resulting in lower doses of Levodopa being used.
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What has current research shown in regards to Selegiline and Parkinsons?
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It has been shown to slow the progression of Parkinson's in RATS. Prolongs their life.
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Anticholinergic drugs are considered....
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Adjunctive therapy for Parkinson's.
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Name a common drug that is an anti-cholinergic but is also used for Parkinson's.
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Benadryl
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How do anticholinergic drugs work?
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Block muscarinic acetylcholine receptors. Alleviate Sx of Parkinson's, esp. tremor and rigidity. Controls SE of antipsychotics.
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How does PT impact Parkinson's?
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-Exercise may improve body strength, so pt is less disabled.
-Exercise improves mobility, ROM, balance while decreasing gait problems. -Strengthen muscles for swallowing/speech -Improve emotional well-being -Improve QOL and function of pt. |
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Things for PT's to remember when working with Parkinson's pts.
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-Impact of disease
-Drug therapy SE, esp CNS, that can affect exercise capacity -Lack of motor control and rigidity can hinder physical performance. |
