Chap 15 Antiparkinson Drugs Flashcards
Parkinson’s Disease and Symptoms
Chronic, progressive, degenerative disorder
imbalance of two neurotransmitters
Dopamine
Acetylcholine (ACh)
Classic symptoms include:
Tremor
Rigidity
Akinesia
Postural instability
TRAP acronym
Staggering gait
Drooling
Psychosis
hallucination
Dyskinesia
Difficulty in performing voluntary movements
Chorea: irregular, spasmodic, involuntary movements of the limbs or facial muscles
Dystonia: abnormal muscle tone leading to impaired or abnormal movements
Levodopa Therapy
Levodopa is taken up by the dopaminergic terminal, converted into dopamine, and then released as needed.
neurotransmitter imbalance is controlled in patients with early PD who still have functioning nerve terminals.
As PD progresses, it becomes more difficult to control it with levodopa.
Ultimately, levodopa no longer controls the PD, and the patient is seriously debilitated.
Rasagiline (Azilect) and Selegiline (Eldepryl)
Used as monotherapy or used as adjuncts with levodopa
Adverse effects
Hypertension
Catechol Ortho-Methyltransferase (COMT) Inhibitors
Tolcapone (Tasmar), entacapone (Comtan)
Adverse effects:
urine discoloration;
Tolcapone associated severe liver failure
Pramipexole (Mirapex)
Used in both early- and late-stage PD
Also used for Restless Leg Syndrome
Anticholinergic Therapy
Anticholinergics have the opposite effects: dry mouth or decreased salivation,
Nursing Implications of Parkinson Disease Drugs
Taking levodopa with MAOIs may result in hypertensive crisis.
should be taught not to discontinue antiparkinson drugs suddenly.
Entacapone may darken the patient’s urine and sweat.
Monitor
improved sense of well-being and mental status
Increased appetite
ability to perform ADLs, to concentrate, and to think clearly
Less intense parkinsonian manifestations, such as less tremor, shuffling gait, muscle rigidity, and involuntary movements
