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2012-06-05 18:44:23
Parkinson Drugs T2

Parkinson's Drugs
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  1. What is Parkinson's Disease?
    Progressive neurologic condition affecting mood, cognition, swallowing, and communication

    2nd most common neurodegenerative condition

    Condition develops as cells which produce dopamine degenerate and die, resulting in a depletion of this neurotransmitter. Will therefore effect ALL of the neural system.

    Dopamine produced in the substantia nigra in the basal ganglia

    • Hallmark symptoms of PD
    • Bradykinesia
    • Rigidity or stiffness of muscles --> balance problems.
    • Tremor
  2. Parkinson's Risk Factors
    • Men more likely to develop
    • Can present at any age—prior to 30—rare
    • Those aged over 80—1 in 50 will have the disease
    • Head trauma/concussions.
    • Professions dealing with CO.
  3. What are some Preliminary or Preclinical Symptoms of Parkinson's Disease?
    • Impaired sense of smell
    • Sleep disturbances
    • Constipation
    • Depression
    • Restless leg syndrome
  4. Parkinson's Treatment
    • Treatment may take several weeks to manifest changes
    • Side effects are common and often problematic
    • A diagnosis requires notification of DMV
    • Treatments are geared toward decreasing the decay of dopamine or replacing it.
  5. Parkinson's Rx intervensions
    Anticholinergics: Trihexyphenidyl (Artane). Antagonize the transmission of ACH in the CNS.—Leads to decreased rigidity

    • Benzotropine (Cogentin)
    • Biperiden (Akineton)

    • Side Effects
    • Dry mouth
    • Constipation
    • Urinary retention
    • Dysarthria
    • Blurred vision
    • Changes in memory
    • Confusion
  6. Actions of Parkinson's Drugs
    Block the reuptake and storage of catecholamines, allowing for the accumulation of dopamine

    Antivirals -Amantadine (Off label usage)


    • Positive effects may not last more than 3 months
    • Side effects
    • Mental confusion
    • Visual disturbances
  7. Levodopa (Sinemet) for Parkinson's
    • Restores deficient dopamine to the brain, but become resistant to the Rx. After a while, it loses its efficacy all together.
    • Carbidopa blocks peripheral conversion of levodopa
    • Interventions
    • Monitor for SE
    • NV
    • Orthostatic hypotension
    • Dry mouth
    • Constipation
    • Sleep disturbance
    • Confusion
    • Hallucinations
    • Increased libido
  8. Dopamine Agonist For Parkinson's
    Bromocriptine (Parlodel)
    Directly stimulates dopamine receptors and increases the effect of levodopa

    Monitor for SE

    • Same as L-dopa
    • Mental dysfunction common
  9. Monoamine oxidase B inhibitor For Parkinson's
    • Monoamine oxidase B Inhibitor
    • Blocks the metabolism of dopamine---thus slowing the underlying disease process

    • Monitor for SE
    • Orthostatic hypotension
    • Maybe given in combination with levodopa
  10. COMT ihibitors
    • Increased availability of levodopa by inhibiting COMT, thus increasing available CNS dopamine
    • COMT= Catechol O-methyltransferase

    • Monitor for SE
    • Orthostatic hypotension
    • Diarrhea
    • NV
    • Hepatic failure