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NRSG 210 > chapter 21 & 23 neuro musc meds > Flashcards

chapter 21 & 23 neuro musc meds Flashcards

1
Q

what is the definition of neurodegenerative diseases**

A

progressive irreversible loss of neuron function in the brain and or spinal cord

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2
Q
A
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3
Q

what is a common problem with neurodegenerative diseases **

A

depression

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4
Q

what are signs and symptoms of parkinson’s disease

A

tremors
muscle rigidity
Bradykinesia (slow movement)
postural instability

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5
Q

what is the pathophysiology of parkinson’s disease

A

it is caused by a lack of dopamine production from the substantia nigra and since there is a lack of dopamine AcH has a more dramatic effect

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6
Q

what is the goal of pharmacotherapy for parkinson’s disease **

A

the goal is to balance dopamine and acetylcholine

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7
Q

how long may a pt have to wait until the see benefits of parkinson’s disease pharmacotherapy **

A

may take 2-3 weeks to see benefits

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8
Q

what are the two main general classes of drugs that are used to treat parkinson’s disease***

A

Dopamine agonists
Anticholinergics

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9
Q

what is a major adverse effect that can result from a lack of dopamine in striatum and what is it ***

A

Major adverse effect of this is Extrapyramidal symptoms which are basically the same as symptoms of parkinson’s disease

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10
Q

what is the most effective pharmacotherapy to treat parkinson’s disease with its brand name

A

Dopamine (levodopa)

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11
Q

what type of food should you avoid while taking levodopa**

A

avoid multivitamins with B6 and high protein diets

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12
Q

what are 4 things that should be monitored while taking levodopa **

A

-ANS vital signs
-safe ambulation (due to dizziness)
-liver and kidney function
-behavioural changes (aggression/ confusion)

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13
Q

what is more effective levodopa or dopamine agonists

A

levodopa but dopamine agonists are used as combo therapy with levodopa

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14
Q

what type of drug is pramipexole

A

dopamine agonist

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15
Q

what are 3 considerations for pramipexole **

A

-monitor for orthostatic hypotension
-monitor for tardive dyskinesia (abnormal movements)
-sleep attacks

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16
Q

what is the prototype anticholinergic drug**

A

Benztropine

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17
Q

What are adverse effects of Benztropine***

A

Think about anticholinergic so reduces the effect of the rest and digest
-sedation
-constipation
-blurred vision
-dry mouth
-decreased sweating
-urinary retention
-confusion

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18
Q

what is a serious adverse effect of benztropine ***

A

paralytic ileus (paralyzed intestine)

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19
Q

what are the contraindications for benztropine**

A

Think what will happen when you block the rest and digest and fight or flight takes over
-narrow angle glaucoma
-myasthenia gravis*
-tardive dyskinesia*
-gi/urinary obstruction
-prostatic hypertrophy*
-peptic ulcers
-tachycardia
-NO alcohol*

20
Q

what drugs can cause added toxicity to benztropine***

A

-antihistamines
-tricyclic antidepressants
-phenothiazines
-MAOI’s
-quinidine

21
Q

what are 3 drug interactions that can occur with benztropine **

A

-drugs that create additive toxicity
-drugs that have and additive sedative effect
-any drugs that slow GI motility/decrease

22
Q

what pregnancy category is benztropine ***

A

Category C

23
Q

what is the treatment for anticholinergic intoxication/overdose**

A

physostigmine 1-2 mg subcutaneous or IV

24
Q

how effective is the pharmacotherapy of alzheimer’s disease **

A

it only produces modest results and is ineffective at stopping the progress of the disorder

25
Q

does pharmacotherapy for alzheimer’s disease promote the PNS or SNS

A

promotes the functioning of the PNS

26
Q

what is the main cholinesterase inhibitor with its brand name **

A

Tacrine (cognex)

27
Q

what is the main adverse effect of Tacrine (cognex) **

A

GI system is heavily affected

28
Q

what is the prototype reversible cholinesterase inhibitors **

A

Donepezil

29
Q

which drug has less side effects donepezil or tacrine***

A

Donepezil has fewer side effects

30
Q

what are some serious adverse effects of donepezil **

A

dysrhythmias
seizures
renal failure

31
Q

how do you treat a anticholinesterase overdose**

A

anticholinergic drugs

32
Q

what is the pathophysiology of MS **

A

characterized by demyelination of neurons secondary to an inflammatory response

33
Q

what is the leading cause of neurological disability in the 20-40 age group **

A

MS

34
Q

what is the only approved drug for ALS treatment with its brand name

A

Riluzole (rilutek)

35
Q

what are the three classed of drugs that are used to treat muscle spasms **

A

-NSAIDS
-muscle relaxants
-centrally acting muscle relaxants

36
Q

what is the prototype central acting skeletal muscle relaxant**

A

Cyclobenzaprine

37
Q

what are 4 drugs similar to cyclobenzaprine **

A

Methocarbamol
Metaxalone
Orphenadrine
tizanidine

38
Q

What is methocarbamol used for**

A

central sedative effects that reduce spasms and as an adjunct to physical therapy (robaxin)

39
Q

what is metaxalone used for**

A

relief of muscle spasms but is an ineffective treatment for spasticity related to neurological disorders

40
Q

what is orphenadrine used for **

A

relief of muscle spasms because it causes prominent anticholinergic effects

41
Q

What is Tizanidine used for **

A

relief of spasticity related to brain or spinal cord injuries

42
Q

what causes irritable deep tendon reflexes and scissoring movements of lower extremities muscle spasms or spasticity?

A

Muscle spasticity

43
Q

what is the therapeutic classification of dantrolene***

A

Direct acting skeletal muscle relaxant that is effective against spacticity

44
Q

what is especially important to monitor when a pt is taking dantrolene **

A

Liver function

45
Q

what herbal remedies can help muscle spasms and spasticity**

A

Black cohosh
Castor oil
Capsaicin

46
Q

what vitamin can help with muscle spasms and spasticity**

A

Vitamin B6

NRSG 210 (19 decks)

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