Parkinson and Alzheimer disease

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created 4 months ago by Akosua_Ruby
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Pharmacology
Chapters 20, 21
updated 4 months ago by Akosua_Ruby
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1

pathophysiology of Parkinson disease

  • chronic neurologic disorder
  • imbalance of neurotransmitters dopamine and acetylcholine
  • degeneration of dopaminergic neurons leading to lack of dopamine
2

what frequently occurs as an adverse reaction to various drugs, carbon monoxide, manganese, or disorders?

pseudoparkinsonism

3

what is the main function of Parkinson and Alzheimer disease drugs

main function is to replace Ache and dopamine

4

what are some characteristics you would see in a patient with Parkinson disease

  • involuntary tremors of limbs
  • rigidity of muscles
  • bradykinesia
  • postural changes
5

benztropine mesylate inhibits the release of what? what is the drug used for

  • it is a parasympatholytic that inhibits the release of acetylcholine
  • used for drug-induced Parkinsonism
6

after your client was administered benztropine mesylate, she experienced an adverse effect. what are the signs?

  • blurred vision
  • ocular hypertension
  • weakness
  • dry mouth
  • urinary retention
7

should you give carbidopa-levodopa to a patient with narrow angled glaucoma?

no, because if the ocular hypertension SE

8

can carbidopa or levodopa be taken alone?

no. they need to be taken together for an effect to happen

9

MOA of carbidopa-levodopa. what's the use?

  • carbidopa drives levodopa to its destination before it breaks down.
  • it is used to treat Parkinson's and relieve tremors and rigidity
10

the SE of carbidopa-levodopa are dry mouth, blurred vision, dysrhythmia, urinary retention, agranulocytosis. also known as_____

anticholinergic toxicity

11

how many times should carbidopa-levodopa be taken for a therapeutic effect?

3-4 times a day because it has a fast half life

12

should tolcapone (tasmar) be taken alone? what should you check before administering? what is it in conjunction with?

  • should never be taken in isolation.
  • check LFT before taking and every 2 weeks
  • only administer in conjunction with levodopa
  • it's a last resort drug due to AE
13

MOA of tolcapone and use

  • it carries levodopa to it's receptor site and increases duration of drug in the body
  • it is used for idiopathic PD
14

tolcapone has severe AE that affect majority of the body system. what are they?

  • CNS
  • cardiovascualr
  • dermatologic
  • GI
  • respiratory
  • fulminant liver failure
15

tolcapone is contraindicated in______

liver disease due to it's severe AE

16

alzheimer disease

  • incurable dementia illness
  • marked cognitive dysfunction
  • onset between 45-65
17

pathophysiology of alzheimer disease

  • not enough acetylcholine
  • plaques
  • tangle in neurons
18

what are some symptoms of alzheimer disease?

  • memory loss, confusion
  • inability to communicate
  • aggressive behavior, depression, psychoses
19

what is the goal of therapy for Alzheimer's disease

  • slow memory and cognition loss
  • bring about slight improvement in cognition and function
20

acetylcholinesterase inhibitors

  • rivastigmine MOA
  • use
  • allow more acetylcholine in neuron receptors
  • improves memory loss in alzheimer disease
21

what should the nurse monitor for in a client taking rivastigmine?

  • confusion
  • dry mouth
  • bradycardia
  • orthostatic hypotension
  • hepatotoxicity
  • suicidal ideation
22

you're teaching your patient about how rivastigmine is taken. you know the teaching has being effective when your patient states_____

"I should take my medication without food"

23

your patient's daughter asks you why they can't take rivastigmine with food. how should you respond?

if you take it with food, food competes with binding site and slows the action of the drug

24

which side effect of carbidopa-levodopa Does the nurse realize is most important to monitor?

agranulocytosis

25

pathophysiology of Myasthenia graves

  • autoimmune
  • antibodies attach to acetylcholine receptor sites and destroy it
  • lack of acetylcholine impairs transmission of messages
  • remission and exacerbation
26

lack of transmission of messages at neuromuscular junctions in MG leads to____

  • ineffective muscle contraction and muscle weakness
  • weakness of respiratory, facial, extremity muscles
27

characteristics of myasthenia graves

  • skeletal muscle weakness
  • fatigue, ptosis
  • respiratory muscle weakness, paralysis and arrest
28

what test is done to diagnose myasthenia gravis? what will happen If the patient has MG? what will happen if the patient does not have MG?

edrophonium or tensilon test. their function will temporarily improve. their condition will worsen

29

myasthenia crisis is caused by what? what are s/s?

  • underdosing
  • severe generalized muscle weakness
30

what can trigger a myasthenic crisis

  • inadequate dosing
  • emotional stress
  • menses, pregnancy
  • hypokalemia
31

what do you use to treat a myasthenic crisis?

neostigmine

32

a cholinergic crisis within 30-60 minutes after taking what? what triggers it

  • anticholinergic medications
  • overdosing
33

what are some S/S of a cholinergic crisis?

  • severe muscle weakness
  • possible respiratory paralysis and arrest
  • excess salivation
  • bradycardia
34

what makes a cholinergic crisis worse. what is the antidote?

  • administration of edrophonium or tensilon test
  • atropine
35

the MOA of pyridostigmine is to

prevents the destruction of acetylcholine

36

what is pyridostigmine used for

MG, neuromuscular blockage, nerve gas exposure prophylaxis

37

when pyridostigmine is taken, the AE is everything slows down. what are the AE?

  • increased salivation and tearing
  • miosis, blurred vision
  • bradycardia, hypotension
  • GI distress
38

what drugs/procedures can be given if the patient is unresponsive to acetylcholinesterase inhibitors

  • prednisone
  • plasma exchange
  • immunosuppressive drugs
  • IV immune globulin
39

pathophysiology of multiple sclerosis

  • autoimmune disorder
  • causes lesions
  • attacks myelin sheath in brain and spinal cord
40

characteristics of multiple sclerosis

  • remissions and exacerbations
  • weakness or paralysis of extremities, fatigue
  • blurred vision, vertigo, tinnitus
41

what is the diagnostic test for MS

there is no specific diagnostic test.

42

what are the indicators of diagnosis for MS

  • medical history
  • neurologic exam
  • multiple lesions observable through MRI
  • visual evoked potential
  • elevated immunoglobulin G in cerebrospinal fluid
43

what is the MOA of beta-interferon

interacts with specific receptor sites on cell surfaces

44

what is beta-interferon used for

decrease number and severity of MS attacks, slows progression of disability

45

should patients with liver conditions take beta-interferon?

no, but monitor liver enzymes while on this medication

46

what are the AE of beta-interferon

myelosuppresion, hepatitis, neutropenia, myalgia anaphylaxis, flulike symptoms