Chapter 23 : Drugs For Neurological Disorders: Parkinsonism And Alzheimers

Front 1

Dopamine

Back 1

An inhibitory neurotransmitter. Maintains control of acetylcholine and inhibits it's excitatory response.

Front 2

Acetylcholine

Back 2

An excitatory neurotransmitter.

Front 3

What happens when you have an increased stimulation GABA in Parkinsons disease?

Back 3

Symptomatic movement disorders occur

Front 4

Treatment regimen for Parkinsonism "Anticholinergics"

Back 4

Block cholinergic receptors

Hint 4

X

Front 5

Treatment regimen "dopaminergics"

Back 5

Convert to dopamine (which increases mobility)

Hint 5

->

Front 6

Treatment regimen "dopamine agonists"

Back 6

Stimulate dopamine receptors

Hint 6

Sts

Front 7

Treatment regimen "MAO-B inhibitors"

Back 7

Inhibit MAO-B enzyme that interferes with dopamine

Hint 7

/

Front 8

Treatment regimen "COMT inhibitors"

Back 8

Inhibit COMT enzyme that inactivates dopamine

Hint 8

/

Front 9

Anticholinergics are sympatholytics or parasympatholytics?

Back 9

Parasympatholytics

Front 10

Examples of anticholinergics

Back 10

Benzotropine (Cogentin)

Trihexyphenidyl HCL (Artane)

Biperiden (Akineton)

Front 11

Action of anticholinergics

Back 11

Inhibit the release of acetylcholine.

Reduce the rigidity and some tremors.

Minimal effect on bradykinesia.

Used to treat DRUG INDUCED Parkinsonism.

Hint 11

4 things

Front 12

Nursing interventions for anticholinergics

Back 12

Monitor vitals.

Monitor urine for early detection of retention.

Increase fluid intake, fiber, and exercise to avoid constipation.

Observe for involuntary movements.

Advise to avoid alcohol, cigs, caffeine, and aspirin to decrease gastric acidity.

Encourage to relieve dry mouth with ice chips, hard candy, and sugar free gum.

Suggest sunglasses for photophobia.

Hint 12

7 things

Front 13

Example of dopaminergics

Back 13

Carbidopa-levodopa (sinemet)

Front 14

Side effects of dopaminergics

Back 14

Fatigue, insomnia, dry mouth, blurred vision, orthostatic hypotension, palpitations, dysthymias, urinary retention, nausea, vomiting, dyskinesia, psychosis, and severe depression

Hint 14

14 things, know the important ones

Front 15

Carbidopa-levodopa (Sinemet) interactions that decrease sinemet effect

Back 15

Anticholinergics, phenytoin, tricyclic antidepressants, MAO inhibitors, benzodiazepines, phenothiazines, vitamin B6

Hint 15

7 drugs

Front 16

Example of dopamine agonists

Back 16

Amantadine (Symmetrel)

Front 17

Amantadine (Symmetrel) can also be used as an ____________________

Back 17

Antiviral drug for influenza A

Front 18

Amantadine (Symmetrel) can be taken alone or in combination with ________ or _______________

Back 18

Levodopa or anticholinergic

Front 19

Amantadine (Symmetrel) use

Back 19

Early treatment of Parkinsonism as drug tolerance develops.

Improvement of symptoms.

Hint 19

2 things

Front 20

Nursing interventions for amantadine (Symmetrel)

Back 20

Monitor for orthostatic hypotension.

Administer drug with LOW protein foods.

Avoid vitamin B6, alcohol, other depressants.

Do not abruptly discontinue.

Warn of harmless BROWN discoloration of URINE AND SWEAT.

Assess for suicidal tendencies.

Assess symptoms status and "on-off" phenomenon.

Monitor blood cell counts, liver and kidney fxn.

Hint 20

8 things

Front 21

Why should amantadine be taken with low protein foods?

Back 21

To decrease GI upset.

High-protein foods interfere with drug transport to CNS

Hint 21

2 things

Front 22

What kind of foods are high in vitamin b6?

Back 22

Lima, navy, kidney beans. And cereals.

Hint 22

4 things

Front 23

Vitamin b6 inhibits conversion of ________ to ________

Back 23

Levodopa, dopamine

Front 24

What happens if you abruptly discontinue amantadine (Symmetrel)?

Back 24

Rebound parkinsonism

Front 25

Acetylcholinesterase inhibitors / Cholinesterase inhibitors (examples)

Back 25

Tacrine (Cognex)

Donepezil (Aricept)

Rivastigmine (Exelon)

Galantamine (Razadyne)

Hint 25

4 drugs

Front 26

Action of Acetylcholinesterase / Cholinesterase inhibitors

Back 26

Allow more acetylcholine in neuron receptors.

Increase cognitive fxn.

Hint 26

2 things

Front 27

Acetylcholinesterase/ Cholinesterase inhibitors are used for what level of Alzheimers

Back 27

Mild to moderate

Front 28

Rivastigmine (Exelon) increases the amount of ___ at the ___________ synapses

Back 28

ACh, cholinergic

Front 29

Side effects of Rivastigmine (Exelon)

Back 29

Anorexia, nausea, vomiting, diarrhea, constipation, abdominal pain, GI bleed, dizziness, depression, peripheral edema, dry mouth, dehydration, restless leg syndrome, nystagmus

Front 30

Adverse effects of Rivastigmine (Exelon)

Back 30

Seizures, bradycardia, orthostatic hypotension, cataracts, myocardial infarction, heart failure