pharm:degen.neuro

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Author:
itzlinds
ID:
268136
Filename:
pharm:degen.neuro
Updated:
2014-03-27 00:55:27
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pharm degen neruo
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Description:
degnerative neurological disorders
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  1. a significant loss of the cells in the substantia nigra that produce dopamine for the rest of the corpus stratium is called:
    parkinsons disease
  2. the decrease in dopamine allows which NT's stimulating effects to predominate:
    acetylcholine
  3. the end goal of PD drugs is to restord the fxn'al balance b/w ACh and dopamine, list the 2 general mechanisms in which PD drugs accomplish this:
    • increase dopamine (dpaminergic drugs)
    • decrease ACh in the corpus statium (anti-cholineragic drugs)
  4. extrapyrimidal side effects (parkinson like symptoms), are often seen in the older generation of drugs used to tx psychosis:


    what is the antidote for actue EPS:
    anti psychotics (dopamine antagonists)

    tx of acute EPS: diphenhydramine IV
  5. the class of PD drugs are are given to increase dopamine in the corups staitum are called:
    dopaminergics
  6. the dopamine precursor that increases dpamine production in the substantia nigra nerve terminals is called:
    Levodopa
  7. what is the reason that dopamine is not used as a synthetic drug to tx PD:
    synthetic dopamine cannot cross the blood brain barrier, so little would be delivered to the cells that need it
  8. named the drug when given combined with Levodopa can enhance levodopa, as well as enzymatic breakdown decreased:
    carbidopa (sinemet)
  9. list 2 important reasons why carbidopa (sinemet) should never be abruptly stopped:
    • a parkinsonian crisis can occur
    • neuroleptic malignant syndrome can occur
  10. list 2 dopaminergics for tx'ing PD:
    • levodopa
    • carbidopa (sinemet)
  11. how long does it take for carbidopa (sinemet) to peak:

    what is the pregnancy category:
    • how long does it take for carbidopa (sinemet) to peak:¬† 1-3
    • pregnancy category: C
  12. what are the adverse effects of dopaminergic meds:
    • increased involuntary movements
    • neausea/vomitting
    • orthostatic hypotension
    • decreased appetite

    if OD: muscle twitching
  13. what are the contraindications of dopaminergics: (2)
    • psyhcosis especially if recent acute episod
    • use of MAIOs
  14. pt. care for dopaminergic  drug tx should include instructions of the following: (3)
    • put orthostatic hypotension precautions in effect
    • monitor for confusion and increased aggression
    • frequently chekc for muscle spasm and eyelid spasm as there are early signs of overdose
  15. pt. education for dropaminergic drug tx should include the following: (4)
    • immediately report eyelid/muscle spasm (early sign of overdose)
    • tell them to change position slowly (orthostatic hypotension)
    • take levodopa on an empty stomach
    • its normal for sweat/urine to darken whil on the rx
  16. list 2 PD drugs that increase doamine by inhibiting enzymes that break down levodopa and dopamine:
    • entacapone (comtan)
    • selegiline (eldepryl)
  17. name the COMT inhibitor that helps to decrease the fluctuations in motor fxn associated with decreasing dopamine levels:
    entacapone (comtan)
  18. list the side effects of entacapone (comtan), the COMT inhibitor that helps to decrease the fluctuations in motor fxn assoicated with decreaseing dopamine levels:
    • neausea/vomiting
    • diarrhea
    • confusion
    • hallucinations
    • potentially hepatotoxic
  19. the class of PD tx that act as dopamine substitues is called:

    list (1) important drug in this class:
    dopamine agnoist

    pramipexole (mirapex)
  20. the class of PD tx that blocks Ach and thus allows more dopaminergic input is called:

    list (3) characterstics, as to when it is used in PD tx, ect:
    anticholinergics

    • they are used early in the course of PD
    • rarely used as sole tx of PD
    • not as effective as L-dopa
  21. list the anticholinergic use to tx PD
    trihexyphenidyl HCl (artante)

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