Antiparkinson Drugs

Question 1

Parkinson’s Disease

Answer 1

Chronic, progressive, degenerative disorder
Affects dopamine-producing neurons in the brain
Caused by imbalance of dopamine and acetylcholine
Symptoms occur when 80% of the dopamine stored in the substantia nigra is depleted

Question 2

Amantadine (Symmetrel)

Answer 2

Antiviral drug used for treatment of influenza

Causes release of dopamine and other catecholamines that have not yet been destroyed by the disease process and blocks reuptake of dopamine into nerve fibers

Used early in the course of disease and is only effective for 6-12 months

Question 3

Adverse Effects of Amantadine

Answer 3

Dizziness, insomnia, and nausea

Question 4

Drug Interactions of Amantadine

Answer 4

Increased anticholinergic adverse effects when given with anticholinergic drugs

Question 5

Catechol Ortho-Methyltransferase Inhibitors

Answer 5

Block COMT, the enzyme that catalyzes the breakdown of the body’s catecholamines

Prolong duration of levodopa

Question 6

Nondopamine Dopamine Receptor Agonists

Answer 6

Work by direct stimulation of presynaptic and/or postsynaptic dopamine receptors in the brain

Question 7

Bromocriptine (Parlodel)

Answer 7

Works by activating presynaptic dopamine receptors to stimulate the production of more dopamine

Also inhibits production of prolactin

Caution when used for patients with PVD

Question 8

Adverse Effects of Bromocriptine

Answer 8

GI upset
Dyskinesias
Sleep disturbances

Question 9

Drug Interactions of Bromocriptine

Answer 9

Erythromycin and adrenergic drugs

Question 10

Carbidopa-Levodopa (Sinemet)

Answer 10

Carbidopa is adjunct to treat nausea associated with Sinemet

Best taken on an empty stomach to minimize GI side effects

Drug interactions with tricyclic antidepressants

Question 11

Anticholinergic Therapy

Answer 11

Anticholinergics block the effects of acetylcholine

Used to treat muscle tremors and muscle rigidity

Does not relieve bradykinesia

Question 12

Acetylcholine SLUDGE

Answer 12

Increased Salivation, Lacrimation, Urination, Diarrhea, GI motility, and Emesis

Anticholinergics reverse these effects

Question 13

Benztropine (Congentin)

Answer 13

Anticholinergic drug used for PD and extrapyramidal symptoms from antipsychotic drugs

Causes hyperthermia

Avoid alcohol

Question 14

Adverse Effects of Benztropine

Answer 14

Tachycardia
Confusion
Disorientation
Toxic psychosis
Urinary retention
Dry throat
Constipation
Nausea
Vomiting
Anticholinergic syndrome

Question 15

Nursing Interventions

Answer 15

Monitor for orthostatic hypotension, administer with low-protien foods, avoid B6, avoid alcohol, do not abruptly discontinue