Module 2 Active Reading Guide

Question 1

What is Parkinson’s Disease?

Answer 1

A neurodegenerative disorder caused by the progressive loss of dopamine-producing neurons.

Question 2

What are Dopaminergic Agents?

Answer 2

Drugs that increase the effects of dopamine in the brain.

Question 3

What are Anticholinergic Agents?

Answer 3

Drugs that block the effects of acetylcholine in the central nervous system.

Question 4

What is Carbidopa-Levodopa?

Answer 4

Combination drug used to increase dopamine levels in the CNS.

Question 5

What are Extrapyramidal Symptoms (EPS)?

Answer 5

Motor side effects often caused by dopamine-blocking antipsychotics.

Question 6

What do COMT Inhibitors do?

Answer 6

Adjunctive drugs that prolong the effects of levodopa by inhibiting its metabolism.

Question 7

What are MAO-B Inhibitors?

Answer 7

Prevent breakdown of dopamine by inhibiting monoamine oxidase-B enzymes.

Question 8

What is Benztropine used for?

Answer 8

An anticholinergic used to treat EPS or drug-induced parkinsonism.

Question 9

What is Entacapone?

Answer 9

A COMT inhibitor used in combination with carbidopa-levodopa to manage wearing-off symptoms.

Question 10

How can Iron Salts affect levodopa?

Answer 10

Can interfere with the absorption of levodopa, reducing its effectiveness.

Question 11

What leads to motor symptoms in Parkinson’s Disease?

Answer 11

Dopamine depletion leads to an imbalance between dopamine and acetylcholine, resulting in tremors, rigidity, and bradykinesia.

Question 12

What role does Carbidopa play in Parkinson’s treatment?

Answer 12

Prevents peripheral breakdown of levodopa, allowing more to reach the brain.

Question 13

In which patients are Anticholinergic agents preferred?

Answer 13

In younger patients with tremor-predominant Parkinson’s or drug-induced parkinsonism.

Question 14

What do COMT inhibitors do?

Answer 14

Extend the half-life of levodopa.

Question 15

What is the function of MAO-B inhibitors?

Answer 15

Prevent dopamine breakdown.

Question 16

What should nursing assessments include for patients on Parkinson’s medications?

Answer 16

Monitoring motor function, liver enzymes, orthostatic vitals, and signs of dyskinesia.

Question 17

What is the Autonomic Nervous System (ANS)?

Answer 17

Works with the endocrine system to maintain internal homeostasis.

Question 18

What does the Sympathetic Nervous System (SNS) do?

Answer 18

Prepares the body for fight or flight.

Question 19

What is the function of the Parasympathetic Nervous System (PNS)?

Answer 19

Supports functions like digestion and rest.

Question 20

What are Adrenergic Receptors?

Answer 20

Receptors that respond to norepinephrine and epinephrine.

Question 21

What are Alpha Receptors responsible for?

Answer 21

Vasoconstriction.

Question 22

What do Beta-1 Receptors primarily affect?

Answer 22

The heart.

Question 23

What is the role of Beta-2 Receptors?

Answer 23

Cause bronchodilation and affect glucose metabolism.

Question 24

What are Cholinergic Receptors?

Answer 24

Receptors that respond to the neurotransmitter acetylcholine.

Question 25

Where are Muscarinic Receptors located?

Answer 25

In the GI tract, bladder, and heart.

Question 26

What is the function of Nicotinic Receptors?

Answer 26

Found in ganglia and at the neuromuscular junction.

Question 27

What is an example of a Direct-Acting Cholinergic Agonist?

Answer 27

Bethanechol.

Question 28

What is an example of an Indirect-Acting Cholinergic Agonist?

Answer 28

Pyridostigmine.

Question 29

What is Donepezil used for?

Answer 29

Management of Alzheimer’s disease.

Question 30

What is Cholinergic Crisis?

Answer 30

A potentially life-threatening condition characterized by excessive muscarinic stimulation.

Question 31

What does SLUDGE stand for?

Answer 31

Salivation, lacrimation, urination, diarrhea, GI cramping, and emesis.

Question 32

What is Atropine used for?

Answer 32

An antidote used to treat cholinergic toxicity.

Question 33

What is Myasthenic Crisis?

Answer 33

An acute exacerbation of myasthenia gravis due to underdosing.

Question 34

What happens when acetylcholinesterase is inhibited?

Answer 34

More ACh stays in the synapse for a longer time, resulting in stronger and longer-lasting nerve signals.

Question 35

What are the effects of Adrenergic Antagonists?

Answer 35

Inhibit the action of norepinephrine.

Question 36

What do Alpha Blockers do?

Answer 36

Cause vasodilation.

Question 37

What is the effect of Beta-Blockers?

Answer 37

Decrease heart rate and contractility.

Question 38

What are Non-Selective Beta Blockers?

Answer 38

Block both beta-1 and beta-2 receptors.

Question 39

What are Selective Beta-1 Blockers?

Answer 39

Act on the heart.

Question 40

What is Labetalol used for?

Answer 40

Severe hypertension.

Question 41

What is Propranolol used for?

Answer 41

Hypertension, angina, and migraine.

Question 42

What is Atenolol preferred for?

Answer 42

Clients with asthma.

Question 43

What is Orthostatic Hypotension?

Answer 43

Due to reduced venous return.

Question 44

What is Bronchospasm?

Answer 44

Adverse effect in asthma with non-selective blockers.

Question 45

What should patients taking alpha blockers be advised to do?

Answer 45

Change positions slowly, sit or lie down if dizzy, take medications at bedtime.

Question 46

What is the dosage calculation for a drug given at 0.05 mcg/kg/min for a 50 kg patient?

Answer 46

2.5 mcg/min.

Question 47

How do adrenergic antagonists lower blood pressure?

Answer 47

By blocking the effects of norepinephrine and epinephrine on alpha and beta receptors.

Question 48

What common side effects are associated with alpha blockers?

Answer 48

Dizziness, fatigue, orthostatic hypotension.

Question 49

What is Acetylcholinesterase?

Answer 49

It's an enzyme that breaks down acetylcholine (ACH) in the synaptic cleft ## Footnote This stops the signal between nerves once ACH has done its job.

Question 50

What happens when you inhibit Acetylcholinesterase?

Answer 50

More ACh stays in the synapse for a longer time, leading to stronger and longer-lasting nerve signals at cholinergic synapses.

Question 51

What is the effect of increased ACH activity?

Answer 51

* More stimulation of cholinergic receptors * Enhanced muscle movement * Improved memory * Affects heart/GI functions

Question 52

What is Donepezil used for?

Answer 52

Inhibits acetylcholinesterase to help improve memory and thinking in Alzheimer's patients.

Question 53

What is Bethanechol?

Answer 53

A direct-acting cholinergic agonist that mimics acetylcholine to stimulate the bladder and GI tract.

Question 54

What are the clinical uses of Bethanechol?

Answer 54

* Urinary retention * Post-op or postpartum patients who can’t urinate * Non-obstructive GI conditions

Question 55

What is Pyridostigmine?

Answer 55

An indirect-acting cholinergic agonist that inhibits acetylcholinesterase to increase acetylcholine at neuromuscular junctions.

Question 56

What is the clinical use of Pyridostigmine?

Answer 56

Used in Myasthenia Gravis to improve muscle strength by boosting ACh.

Question 57

How can nurses distinguish between myasthenic and cholinergic crisis?

Answer 57

Myasthenic Crisis: Not enough ACh, improves with more ACh. Cholinergic Crisis: Too much ACh, worsens with more ACh.

Question 58

What are the key signs of Myasthenic Crisis?

Answer 58

* Severe muscle weakness * Difficulty breathing * Improves with more ACh

Question 59

What are the key signs of Cholinergic Crisis?

Answer 59

* Muscle weakness plus SLUDGE: * Salivation * Lacrimation * Urination * Diarrhea * GI cramps * Emesis * Bradycardia * Miosis * Sweating

Question 60

What is the Edrophonium (Tensilon Test) used for?

Answer 60

To differentiate between Myasthenic Crisis and Cholinergic Crisis based on symptom improvement or worsening.

Question 61

What are important teaching points for clients starting Donepezil?

Answer 61

It slows memory loss and improves thinking in Alzheimer’s, potential side effects include N/V/D, dizziness, bradycardia.

Question 62

What are the key side effects of anticholinergic agents?

Answer 62

* Can't see * Can't pee * Can't spit * Can't sh...

Question 63

What are the therapeutic effects of anticholinergic medications?

Answer 63

They block acetylcholine at muscarinic receptors in the parasympathetic nervous system.

Question 64

What conditions are commonly treated with anticholinergic drugs?

Answer 64

* Parkinson’s Disease * Overactive Bladder / Urinary Incontinence * Irritable Bowel Syndrome / GI Disorders * Asthma / COPD * Motion Sickness / Nausea * Eye Exams * Bradycardia

Question 65

What should nurses monitor in clients receiving anticholinergics?

Answer 65

* Blurred vision * Dry mouth * Urinary retention * Constipation * Tachycardia * Confusion

Question 66

What are some management strategies for dry mouth?

Answer 66

* Sip water frequently * Suck on sugar-free candy * Use saliva substitutes * Avoid caffeine and alcohol * Maintain good oral hygiene

Question 67

How do anticholinergics differ from cholinergic agonists?

Answer 67

Anticholinergics block ACh receptors; cholinergic agonists activate ACh receptors.

Question 68

What is a common example of an anticholinergic medication used for motion sickness?

Answer 68

Scopolamine

Question 69

Fill in the blank: Anticholinergic agents block the action of _______ in the parasympathetic nervous system.

Answer 69

acetylcholine