NUR 3145 Exam 4 Practice Questions and Correct Answers
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Course
NUR 3145
Institution
NUR 3145
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 blank expression stooped posture tremors shuffling gait
What is the mechanism of action of park...
NUR 3145 Exam 4 Practice Questions
and Correct Answers
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
Dopamine replacement drugs: carbidopa-levodopa (Sinemet) ✅Levodopa changes
into dopamine in the brain, helping to control movement. Carbidopa prevents the
breakdown of levodopa in the bloodstream so more levodopa can enter the brain.
Carbidopa can also reduce some of levodopa's side effects such as nausea and
vomiting.
What do large doses of levodopa cause? ✅involuntary movements, GI distress,
hypotension and cardiac arrhythmias
what are carbidopa-levodopa (Sinemet) adverse effects? ✅palpitations, hypotension,
urinary retention, depression, dyskinesia
which are Parkinson's Medications
Adjunct meds? ✅anticholinergic and antihistamines
anti-cholinergic drug-Cogentin (benztropine): ✅secondary drug for tremor/muscle
rigidity;
action is to block acetylcholine;
does not help bradykinesia; meds can cross the Blood brain barrier
anti cholinergic for parkinsons
anti-histamine-Benadryl (diphenhydramine): ✅secondary drug for tremor/muscle
rigidity; decreases dyskinesia; anticholinergic properties
adverse effects of adjunct meds for parkinson? ✅urinary retention, confusion, visual
blurring, palpitations, and increased intraocular pressure
what drug is most often prescribed for parkinson? ✅levodopa (used with carbidopa to
suppress nausea)
body metabolizes levodopa to produce dopamine bc injections of dopamine would just
be blocked by the body's defense
Bromocriptine ✅1st line drug for parkinson
improves ability to move, decreases shakiness, stiffness and slowed movement
Parkinson's medication- even __________ late can result in a decrease in function or
being "off" for hours ✅30 minutes
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