NUR 3145 EXAM 4 | COMPLETE QUESTION { ANSWERED} LATEST 2024
What happens in patients with parkinson's? - • A decrease in normal dopamine levels; the nerve cells that produce dopamine break down
• Progressively gets worse over time
s&s of Parkinson's - Mask-like
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What happens in patients with parkinson's? - • A decrease in normal dopamine levels;
the nerve cells that produce dopamine break down
• Progressively gets worse over time
What is the mechanism of action of parkinson's medications? - increase levels of
dopamine or antagonize effects of Ach
What are indirect acting meds for parkinson? - Indirect acting dopaminergic drugs
Dopamine Modulators
COMT Inhibitor
Direct Acting meds for parkinson? - Direct acting dopamine receptor agonist
indirect acting dopaminergic- Selegiline (Zelapar) - indirect acting dopamine receptor
agonists (MAO-B inhibitor)
inhibits the action of the enzyme monoamine oxidase primary role of MAO is the
breakdown of catecholamines (the catecholamines are pi, norepi and dopamine)
prevents breakdown of lepadopa
Selegiline (Zelapar) interactions - can be used with carbidopa-levodopa
cannot be used with meperidine
interaction with tyramine foods;(cheese; wine, beer , yogurt) produces severe
hypertension
when is Selegiline (Zelapar) used? - early stage;adjunct drug for parkinsons
dopamine modulator- amantadine (Symmetrel) - anti viral used in the early stage
nerve fibers release dopamine in the basal ganglia & blocks the reuptake of dopamine
reduces tremor and rigidity
also used for influenza; effective for 6-8 months.
is a dopamine modulator
improves muscle control and reduces stiffness
, adverse effects of amantadine (Symmetrel) - dizziness, insomnia and nausea; this med
has anticholinergic effects, if used with other anticholinergic meds will have additive
effects
What are two types of COMT inhibitor? - talcapone (Tasmar)
entacapone (Comtan)
COMT inhibitor-talcapone (Tasmar) - adjunct drug to carbidopa-levodopa
treats symptoms
levodopa dose-sparing effect.
Works both centrally and peripherally
COMT inhibitor-entacapone (Comtan) - adjunct; Works only peripherally, can not cross
BBB
Adverse effects of talcapone or entacapone - GI upset
urine discoloration associated with severe liver failure
What is the treatment for serotonin syndrome? - discontinuation of all serotonin
reuptake inhibitors and supporting the patient to maintain homeostasis.
How long until you experience benefits from SSRIs? - 4-6 weeks until benefits show up
from this medication
SSRIs should be taken in the _________ to prevent any sleep disturbances. - SSRIs
should be taken in the morning to prevent any sleep disturbances.
In caring for a patient experiencing ALCOHOL withdrawal, the nurse expects to
administer which medication or medication class as treatment for this condition? -
benzodiazepines
which are first line drugs for parkinson? - bromocriptine (Parlodel)
Pramipexole (Mirapex)
Ropinirole (Requip)
they stimulate pre/post synaptic dopamine receptors in the brain to stimulate production
of dopamine
bromocriptine (Parlodel)- Adverse effects - ataxia, dizziness, headache, depression,
Caution: can produce vasoconstriction in peripheral tissues; can worsen PVD
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