NUR 2474 Module 2 PPT QuizPharmacology for Professional Nursing - Rasmussen
Parkinson’s ✓ Too little dopamine; shuffling gait and tremors. Dopamine channels motor impulses tripped by a-choline simultaneously.
To stop tremors and other extrapyramidal systems (EPS) ✓ Replenish dopamine first, then reduce acetylcholine activity.Give dopamine replacement with levodopa/carbidopa (Sinemet). If really needed, block acetylcholine with benztropine (Cogentin).
Prescriptions for Parkinson's tremors and shuffling restore ✓ Dopamine acetylcholine balance
Preferred agent for dopamine replacement ✓ Sinemet (carbidopa/ levodopa). don't crush sustained release tabs
Other meds for Parkinson’s
✓ Entacapone: slows dopa breakdown
✓ Stalevo: Sinemet + entacapone
✓ Pramipexole: stimulates dopa receptors
✓ Amantadine: releases dopamine
✓ Selegiline (Eldep) MAOI-type B
(NONE OF THESE RESTORE IMPAIRED NEURONS) 1 / 2
When giving Sinemet (carbidopa-levodopa) ✓ Must troubleshoot wild imagination ✓ Also causes nausea (give with crackers) ✓ Also causes constipation (try fluids & fiber) ✓ Salt water combination also helps correct orthostatic hypotension (standing dizziness)
Avoid giving antipsychotics (dopamine blockers) ✓ Pimavanserin blocks serotonin 5HT2 a + c receptors to reduce hallucinations
When giving Cogentin (benztropine)
✓ Must troubleshoot anticholinergic effects: thirst, constipation,
urine retention, drowsiness& blurred vision (bad for glaucoma),
Alzheimer's Dementia ✓ Alzheimer's medications calm & sustain thoughts
✓ They do not undo tangles
✓ They do not stop disease progression
Donepezil (Aricept) ✓ Keeps acetylcholine afloat in synapse to enable recall (cholinesterase inhibitor) ✓ Dizziness, headache, urgency diarrhea & GI side effects.bradycardia (cholinergic effects) ✓ These cholinergic symptoms increase fall risk. Report them ✓ Rivastigmine (Exelon) comes as a patch...assure inaccessibility ✓ Titrate doses up and down when starting and stopping Rx
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