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Chapter 24: Antiparkinsonism Agents

Terms in this set (27)

Parkinson's disease
Progressive, chronic neurological disorder
damaged neurons in the basal ganglia
lack of dopamine production in the brain
lack of coordination
Rhythmic tremors
bradykinesia
shuffling gait
mask-like expression
drooling & slowed speech
Difficulty swallowing, often leading to aspiration pneumonia, is a major issue as the disease progresses
Parkinson Features
shuffling gait
what is a hallmark of Parkinson's disease
Drug therapy
primary treatment for parkinson's disease
*levodopa (generic)
*carbidopa-levodopa (Sinemet)
NTK Dopaminergic Agents
Imitate or mimic the actions of dopamine when levels are low
Bind to dopamine receptors found on nerve cells that regulate motor function and body movement
Act directly on postsynaptic dopamine receptors, thus removing the need for metabolic conversion, storage, and release
Dopaminergic Agents pharmacodynamics
Relief of signs & symptoms of idiopathic Parkinson disease
Dopaminergic Agents indications
Allergy
Angle-closure glaucoma
Lactation
Hx or presence of suspicious skin lesions
CV disease, HTN, bronchial asthma, PUD, urinary tract obstruction, psych disorders
Pregnancy
Renal and hepatic disease
Dopaminergic Agents contraindications
Related to stimulation of dopamine receptors
anxiety, nervousness, headache, malaise, fatigue, confusion, mental changes, blurred vision, muscle twitching, and ataxia
Dopaminergic Agents adverse effects
MAOIs
Risk for decreased efficacy of levodopa - vitamin B6 or phenytoin
Risk for reduced efficacy of both drugs - dopamine antagonists (ex. Phenergan, Seroquel, Risperdal)
Risk for decrease in dopaminergic effectiveness - OTC vitamins
Potentially serious reactions (rasagiline) - tyramine-containing foods, St. John's wort, analgesics
Dopaminergic Agents drug-drug interactions
MAOIs
Risk for increased therapeutic effects and hypertensive crisis when Dopaminergic Agents are taken with what?
14 days prior
MAOIs should be stopped ________________ to start w/ a dopaminergic
Assess for allergies
Inspect the skin for evidence of skin lesions or history of melanoma
Nursing Considerations for Patients Receiving Dopaminergic Agents
Arrange to decrease the dose of the drug if therapy has been interrupted for any reason to prevent systemic dopaminergic effects.
Evaluate disease progress and signs and symptoms periodically and record for reference of disease progress and drug response.
Monitor bowel function
Nursing Implementation for Patients Receiving Dopaminergic Agents
benztropine (Cogentin)
diphenhydramine (Benadryl)
NTK Anticholinergic Agents Prototypes
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