Parkinson's Disease

Question 1

define Parkinson’s disease

Answer 1

depigmentation of the substantia nigra of the basal ganglia and loss of neurons

Question 2

In Parkinson’s, there is a depletion of what in the body?

Answer 2

dopamine

Question 3

S&S associated with Parkinson’s Disease

Answer 3

TRIAD: Tremors, Rigidity, Bradykinesia

Question 4

Word for small writing

Answer 4

micrographia

Question 5

With Parkinson’s, pt has what kind of gait and problem with balance?

Answer 5

shuffling gait, and an increased risk of falls

Question 6

Tremors in Parkinson’s occur when?

Answer 6

tremors occur at rest

Question 7

When do the tremors cease in a person who has Parkinson’s?

Answer 7

disappear with purposeful movement

Question 8

What in particular does the patient with Parkinson’s do with their fingers?

Answer 8

“Pill rolling”

Question 9

Rigidity in the TRIAD (tremors, rigidity, and bradykinesia) associated with Parkinson’s, involves what two movements?

Answer 9

unmoving (resistance to passive movement) and cogwheeling (jerks movement)

Question 10

What does festination mean?

Answer 10

shuffling gait

Question 11

In Parkinson’s, the patient experiences the loss of what type of movement?

Answer 11

automatic movement

Question 12

In bradykinesia associated with Parkinson’s, what test might the MD perform in regards to stability?

Answer 12

“Pull test”

Question 13

What kind of posture does the patient with Parkinson’s have?

Answer 13

stooped

Question 14

Name 5 characteristics that fall under bradykinesia

Answer 14

Loss of automatic movements
mask-like face
drooling
stooped posture
shuffling gait (festination)
Postural instability

Question 15

Give the name for the meaning:involuntary movements

Answer 15

dyskinesias

Question 16

what is the word for “total immobility”

Answer 16

akinesia

Question 17

Give 4 complications associated with PD

Answer 17

Dyskinesia (involuntary movement)
Akinesia: total immobility
neurocognitive disorder (dementia)
psychiatric px

Question 18

Drugs that fall under dopamine precursors

Answer 18

Levodopa

Levodopa & carbidopa (Sinemet)

Question 19

Which drug in PD do we give in high doses until the nausea/vomiting mechanism is given signaling a therapeutic level and is lowered for treatment?

Answer 19

carbidopa (Sinemet)

Question 20

Name the drugs that fall under dopamine receptor agonist (3)

Answer 20

bromocriptine (Parlodel)
pramipexole (Mirapex)
ropinirole (Requip)

Question 21

Give the 2 drugs that go under dopamine agonists

Answer 21

amantadine (Symmetrel)

apomorphine (Apokyn)

Question 22

Drug given to pt with PD that helps with hypomobility

Answer 22

apomorphine (Apokyn)

Question 23

Anticholinergic drug given in PD

Answer 23

benzotropine (Cogentin)

Question 24

Antihistamine given to pt with PD

Answer 24

diphenhydramine (Benadryl)

Question 25

Two Monoamine Oxidase Inhibitors (MAO-I) give in PD

Answer 25

selegiline (Eldepryl) | rasagiline (Azilect)

Question 26

What food chemical cannot be give with MAO-I and what does it cause?

Answer 26

tyramine (amino acid)=aged food because it causes brain damage

Question 27

COMT Inhibitors give to pts with PD

Answer 27

entacapone (Comtan) | tolcapone (Tasmar)

Question 28

What teaching must be given to patients associated with their medications?

Answer 28

MUST take meds at the same time qday

Question 29

Name the 3 surgical managements that may be done with a PD pt

Answer 29

Deep brain stimulation Ablation Transplantation

Question 30

What is transplanted in a surgical management for the pt with PD? Whats the problem with this procedure?

Answer 30

fetal neural tissue (its experimental)

Question 31

What is performed in the deep brain stimulation?What is it similar to?

Answer 31

delivery of an electrical current to control S&S | similar to pacemaker

Question 32

What is the most common procedure to perform for surgical management for a pt with PD?

Answer 32

deep brain stimulation

Question 33

In Ablation (surgical management) what three things may be performed for the PD pt?What does each procedure do?

Answer 33

``` Thalamotomy (reduces tremors creating scar tissue) Pallidotomy (improves stiffness) Subthalmic nucleotomy (decreases symptoms) ```

Question 34

Which procedure with the ablation surgical management must be precise due to the possible damage to this nerve?

Answer 34

Pallidotomy due to that it is very close to the optic nerve