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pharmacology exam 2 NUR 2060 -part 2 CNS (1)
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pharmacology exam 2 NUR 2060 -part 2 CNS (1)
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pharmacology exam 2 NUR 2060 -part 2 CNSwhere do central nervous system drugs act and what do they treat? - ANS-brain and spinal cord
-psychiatric disorders, CNS diseases, suppression of seizures, relief of pain, and anesthesia
-nonmedically for stimulant, euphoriant, and mind altering abilities
what are neurotransmitters for CNS? - ANS-serotonin, gaba, endorphins, oxytocin, dopamine,
norepinephrine, epinephrine
what is the blood brain barrier? - ANS--passage across BBB is limited to lipid soluble agents
and drugs that can use transport systems are able to cross
-impedes the entry of drugs into the brain
-protein bound drugs and highly ionized drugs cannot cross
-to treat CNS diseases, drugs must cross bbb
T/F: sometimes it take weeks for a full therapeutic effect for CNS drugs - ANS-True; therapeutic
effects increase over time
T/F: CNS drugs taken chronically may decrease the intensity of the side effects, while the
therapeutic effect remains undiminished - ANS-True
CNS drugs exhibit both ____________ and ________________. - ANS-tolerance- person's
diminished response to a drug, which occurs when drug is used repeatedly and body adapts to
drug;
physical dependence- a state in which abrupt discontinuation of drug use will result in
withdrawal syndrome
what is Parkinson's disease - ANS-chronic, progressive neurodegenerative disorder of the
extrapyramidal system due to degeneration of neurons
what are symptoms of Parkinson's disease - ANS--dyskinesia- abnormal body movements
-akinesia: muscle rigidity
-bradykinesia: slowness of motion
-tremor at rest: early sign, progressive
-postural instability
-arms hang heavy at sides
-voice is barely audible
-speech slurred
-face void of emotion
movement is normal the the inhibitory influence of _____________ and ______________ are in
balance - ANS-dopamine and acetylcholine
, -dopamine is an inhibitory transmitter and Ach is excitatory
-in the striatum
GABA - ANS-inhibits the transmission of action potentials and slows down the brain by blocking
specific signals in the CNS
-regulates muscle tone daily and muscle relaxation during sleep
what are the major categories of drug therapy for Parkinson's disease? - ANS--dopaminergic
agents: promote activation of dopamine receptors
-anticholinergic agents: prevent activation of cholinergic receptors
what are some mechanisms of action of dopaminergic drugs? - ANS--promotion of dopamine
synthesis
-prevention of dopamine degradation
-promotion of dopamine release
-direct activation of dopamine receptors
levodopa (Dopar) - ANS-dopaminergic agent that replaces dopamine to treat Parkinson's
disease
-once it crosses the BBB, it converts to dopamine where it helps restore the balance between
dopamine and Ach in the striatum
can dopamine cross the BBB? - ANS-no
what are some nursing implications for levodopa? - ANS--encourage a low protein diet bc amino
acids compete in intestine for absoprtion
-full effect may take several months
-effect diminishes with time, first two years promising, less after 5
-patients have off and on periods of when the drug is working so it may help to change dosing
schedule
side effects of levadopa - ANS--N/V: give low dose or w food (but food could decrease
absorption
-involuntary movements
-postural hypotension
-dysrhythmias
-confusion, paranoia, visual hallucinations, nightmares
-darkens sweat and urine (harmless)
-hypertensive crisis if taken with monoamine oxidase inhibitors
levodopa/carbidopa (Sinemet) - ANS-dopamine replacement drug for Parkinson's disease
-carbidopa increases the percentage of levodopa available to brain
-decreases stimulation of medullary emetic center so less N/V
-increase stability of symptom control
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