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UC NURS 8024 Module 8 Neuro- Questions and Answers
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UC NURS 8024 Module 8 Neuro- Questions and Answers
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UC NURS 8024 Module 8 Neuro- Questions and Answerscarbidopa Correct Ans-dopamine precursor. enhances effect of levadopa by diminishing
metabolism of levadopa in GI tract and peripheral tissues. Increases availability of levadopa to
cross into CNS.
levodopa/carbidopa combination Correct Ans-potent and effective in treatment.
carbidopa increases bioavailability of levodopa - more CNS availability. levodopa decreases
rigidity and tremors. typical decline in response in 3rd to 5th year of tx.
levodopa ADEs Correct Ans-GI sx, tachycardia, PVCs, postural hypotension, mydriasis (can
precipitate glaucoma). CNS effects: hallucinations, dyskinesias, mood changes, depression,
psychosis, anxiety. CI in hx of psychosis
COMT inhibitors Correct Ans-Catechol-O-Methyltransferase (COMT) inhibitor. Adjunctive
therapy with levodopa-carbidopa. increases concentration of dopamine in CNS. ex:
Entacapone (Comtan). ADE (secondary to inc. levadopa): dyskinesias, GI distress, postural
hypotension. Tolcapone - increased liver enzymes, acute hepatic failure. **Do not use MAOI
and COMT together
distinguishing features of Alzheimer's Correct Ans-accumulation of senile plaques (beta-
amyloid), formation of neurofibrillary tangles, loss of cortical neurons -particularly cholinergic
neurons
cholinesterase inhibitors Correct Ans-management of mild to moderate Alzheimer's. MOA
- block enzyme that degrades ACh, enhances cholinergic transmission. ADE - GI sx, insomnia,
, UC NURS 8024 Module 8 Neuro- Questions and Answers
fatigue, cramps, anorexia. ex: donepezil (Aricept), rivastigmine (Exelon), galantamine
(Razadyne)
NMDA receptor antagonists Correct Ans-Decreases activity of glutamate in synapse,
neuroprotective. mod-severe Alzheimer's. often given in addition to cholinesterase inhibitors.
ex: memantine (Namenda). well tolerated. 100% bioavailability. ADE - constipation,
confusion, dizzy, HA, hallucinations, coughing, HTN. *Dose reduction in renal impairment
drugs used in Parkinsonism Correct Ans-dopamine precursor (levodopa), dopamine
agonists (bromocriptine, pramipexole), MAOI (selegiline), COMT inhibitors (entacopone),
muscarinic antagonists (benztropine)
amantadine Correct Ans-glutamate antagonist (antiviral), enhances dopaminergic
neurotransmission. Used for minor Parkinson's sx, improves bradykinesia, rigidity, tremor.
ADE - dry mouth, restlessness, agitation, urinary retention, post. hypotension, pedal edema.
Caution in seizure disorders and CHF!
Anticholinergic agents Correct Ans-antimuscarinic, decreases the excitatory actions of
cholinergic neurons by blocking muscarinic repectors. Improves tremor and rigidity but not
bradykinesia. ex: benztropine (Cogentin). Caution in elderly, BPH, urinary retention, liver,
renal or GI or GU disease. Can precipitate narrow angle glaucoma. Limited use d/t ADEs
dopamine receptor agonists Correct Ans-effective mild parkinsonism, used in combo with
levodopa. also for restless leg syndrome. ex: pramipexole (Mirapex). ADE - N/V, anorexia,
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