CNS Parkinsons/Alzheimers Flashcards
(36 cards)
What is the mechanism of action (MOA) of carbidopa in antiparkinsonian drugs?
Prevents an enzyme from converting levodopa to dopamine in peripheral too early, allowing more levodopa to reach the brain.
List common side effects of carbidopa/levodopa.
- Confusion
- Chest pain
- Nausea
- Vomiting
- Fatigue
- Discolored bodily fluids (red, brown, or black with saliva, urine, sweat)
What are some adverse effects of carbidopa/levodopa?
- Dopamine toxicity
- Dyskinesia
- Bradykinesia
- Hypotension
- Syncope
- Myocardial Infarction (MI)
- Arrhythmias
What nursing considerations should be taken when administering carbidopa/levodopa?
- Assess mood, suicidal ideation, hallucinations, intense urges
- Periodically monitor AST, ALT, BUN, CREAT, CBC
- Administer on time, preferably before mealtime
- Avoid high protein food
- Therapeutic effects take several weeks
- Contraindicated with MAOIs
- Monitor for ‘On-Off Phenomenon’
What are examples of carbidopa/levodopa medications?
- carbidopa/levodopa (Sinemet)
- carbidopa/levodopa (Parcopa)
What is the MOA of dopamine agonists in antiparkinsonian drugs?
Prevents the reuptake of dopamine to be recycled and promotes the release of dopamine, increasing dopamine in the synaptic cleft.
List some common side effects of dopamine agonists.
- Confusion
- Nausea
- Dizziness
- Insomnia
- Dry Eyes
- Blurred Vision
- Dry Mouth
- Livedo Reticularis
What adverse effects are associated with dopamine agonists?
- Suicide ideation
- Congestive Heart Failure (CHF)
- Peripheral Edema
- Ataxia
What nursing considerations should be monitored with dopamine agonists?
- Assess mood, suicidal ideation, hallucinations, intense urges
- Monitor for Neuroleptic Malignant Syndrome
- Monitor renal function
- Monitor for orthostatic hypotension
What is an example of a dopamine agonist medication?
Amantadine (Gocovri)
What is the mechanism of action of MAO B inhibitors in antiparkinsonian drugs?
Reduces the destruction of dopamine in the brain, allowing greater dopaminergic activity and selectively inhibits MAO-B.
List the side effects of MAO B inhibitors.
- Nausea
- Vomiting
- Drowsiness
- Dizziness
- Constipation
- Dry mouth
What are some adverse effects of MAO B inhibitors?
- Suicide ideation
- Arrhythmias
- Dyskinesia
- High doses can cause hypertensive crisis, Serotonin Syndrome
What nursing considerations should be taken when administering MAO B inhibitors?
- Assess mood, suicidal ideation, hallucinations, intense urges
- Monitor for hypertensive crisis
- Avoid foods high in tyramine
- Monitor for orthostatic hypertension
What are examples of MAO B inhibitors?
- selegiline (Eldepryl)
- rasagiline (Azilect)
What is the mechanism of action of anticholinergics in antiparkinsonian drugs?
Antagonizes acetylcholine to bind to muscarinic receptors, helping with tremors and rigidity.
List common side effects of anticholinergics.
- Drowsiness
- Dizziness
- Urinary Retention
- Constipation
- Dry mouth
What are some adverse effects associated with anticholinergics?
- CNS Effects: Delirium
- Psychosis
- Tachycardia
- Hypertension
What nursing considerations should be monitored with anticholinergics?
- Monitor confusion, hallucination, depression, and psychological behaviors
- Assess HR, ECG, BP
- Monitor for falls
- Monitor for palpitations, chest discomfort, shortness of breath
- Watch for dehydration
What are examples of anticholinergic medications?
- benztropine (Cogentin)
- trihexyphenidyl (Artane)
What is the brand name of the new antiparkinsonian drug approved in August 2024?
Crexont
Crexont is a combination of carbidopa and levodopa.
How many times a day did the Crexont group have to take medication compared to the Sinemet group?
3 times a day for Crexont, 5 times a day for Sinemet.
What are some side effects of Crexont?
- Nausea
- Anxiety
- Dyskinesia
What is a key feature of the carbidopa/levodopa pump approved in 2015?
Continuous infusion of carbidopa/levodopa gel into the small intestine.
