CNS drugs 3 Flashcards
(30 cards)
1
Q
Parkinson’s
A
- most common mvmt dx
- affects extrapyramidal motor tract (posture, balance, & locomotion)
- depletion of dopamine (shuffling)
- increaes of ach (tremors)
- no cure
- drug tx is based on easing the s/s & to assist in maintaining the pt’s mobility & function as long as possible
2
Q
s/s of Parkinson’s
A
- tremors
- rigidity
- akinesia & bradykinesia
- postural instability
- affect is flat
3
Q
drugs used to tx Parkinson’s
A
- anticholinergics
- dopaminergics
- adjunctive
4
Q
s/e of anticholinergics
A
- dry mouth
- blurred vision
- dizziness
- urinary retention
- dysuria
- tachycardia
- muscle weakness
- confusion
5
Q
dopaminergics
A
- act on sympathetic NS
- affect the dopamine content of the brain
6
Q
Levodopa
A
- cannot give alone in the US
- it is converted to dopamine before it enters the brain=large doses needed=too many s/e
- reduces muscle rigidity & tremors
- takes 2-4 months to achieve max benefit
7
Q
Carbidopa
A
inhibits the enzyme so that more levodopa can reach the brain
8
Q
s/e of levodopa
A
- n/v
- dyskinesia
- hypoTN
- cardiac dysrhythmias
- psychosis
- usually seen with high doses
9
Q
early s/s of levodopa toxicity
A
- spasmodic eye winking
- muscle twitching
10
Q
Sinemet
A
- carbidopa-levodopa
- most effective for Parkinson’s, not pseudoparkinsonism
- levodopa crosses the blood brain barrier
- more dopamine reaches the basal ganglia
11
Q
Sinemet s/e
A
- levodopa s/e are not prevalent
- cardiac dysrhythmias
- palpitations
- orthostatic hypoTN
12
Q
disadvantages of Sinemet
A
- using early in the dx may cause s/e to develop more quickly
- pt may stop responding to drug sooner
13
Q
contraindications of dopaminergic drugs
A
- angle closure glaucoma
- suspicious skin lesions associated with the development of melanoma
- CVD
- bronchial asthma
- urinary obstruction
- peptic ulcer dx
14
Q
adjunctive Parkinson’s meds
A
- extend Sinemet’s effectiveness
- delay the need for Sinemet
- used in pts who are unable to tolerate the max dose of Sinemet
15
Q
foods to avoid in Parkinson’s
A
- high in vit B6
- beef, ham, egg yolk, sweet potatoes, oatmeal, fotified cereals
- high protein
16
Q
Alzheimer’s dx
A
- anomia
- apraxia
- agnosia
- amnesia
- aphasia
- terminal dx of brain tissue
17
Q
Alzheimer’s drugs
A
- prevent breakdown of Ach
- don’t cure
- help reduce behavioral problems, improve thinking, judgment, & recognition
- aricept
- namenda
- razadyne
- exelon
18
Q
Aricept
A
- administer qhs
- rifampin=drug/drug interaction
- indication: mild-mod dementia
- caution: dizziness, drowsiness, depression, diarrhea, deep muscle cramps
- elevation in ach
- pt may have bradycardia
- take w/o regard to food
19
Q
Namenda
A
- not to take with renal impairment
- assess for cognitive function
- must not dilute
- dizziness may occur
- neurotransmitter inhibitor
20
Q
Razadyne
A
- reversible AchE inhibitor
- for mild to mod dementia
- take with meals
- bradycardia
21
Q
Exelon
A
- AchE inhibitor
- s/e: GI upset, wt loss
- PO (with meals) & transdermal
22
Q
generalized s/e anti alzheimer’s drugs
A
- HA
- dizziness
- fatigue
- frequent urination
- wt gain/loss
- cardiac dysrhythmias
- change in BP
23
Q
myasthenia gravis
A
- autoimmune
- “grave muscle dx”
- fluctuating muscle weakness & fatigue
- ach receptors are blocked
- lack of ach receptor
24
Q
pharm mgmt of MG
A
- neostigmine (prostigmin)
- pyridostigmine (mestinon)
- endrophonium (tensilon)
25
myasthenic crisis
```
**severe generalized muscle weakness
triggers:
-inadequate dosing
-infection
-emotional stress
-menses
-pregnancy
-surgery
-trauma
-decreased K+
-temperature extremes
-alcohol
-certain meds
```
26
neostigmine
- interferes with breakdown of ach
- improves muscle tone in MG
- has greater effect on skeletal muscle than pyridostigmine
27
pyridostigmine
- cholinesterase inhibitor
- prevents breakdown of ach
- OD=atropine sulfate
28
pyridostigmine contraindications
- GI/GU obstruction
- lung disorders
- kidney dx
- slow/irregular HR
29
pyridostigmine s/e
- n/v
- adb cramps
- increased saliva/mucus
- decreased pupil size
- increased urination or sweating
* life threatening
- respiratory depression
- bronchospasm
- cardiac dysrhythmias
- seizures
30
edrophonium
- used as dx for MG only
- used to differentiate between MG and cholinergic crisis
- if s/s are alleviated: cause is myasthenia crisis
- if muscle weakness is more severe: cause is cholinergic crisis d/t drug OD
