CNS Drugs for Parkinson's, Alzheimer's, MS, Epilepsy & Muscle Spasms
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| How is the CNS different from the PNS with regard to neurotransmitters? (ch 20) | PNS has 3 compounds: acetylcholine, norepinephrine, and epinephrine, but CNS has at least 21 compounds that serve as neurotransmitters
🗑
|
||||
| Lipid-soluble agents and specific transport systems- cross blood-brain barrier? (ch 20) | Yes
🗑
|
||||
| Protein-bound drugs and highly ionized drugs- can cross blood-brain barrier? (ch 20) | No
🗑
|
||||
| Are infants more or less sensitive to CNS drugs than older children or adults? (ch 20) | Infants are much more sensitive to CNS drugs than are older children and adults
🗑
|
||||
| T/F We do not fully understand the brain in either health or disease (ch 20) | True
🗑
|
||||
| What are some of the adaptive changes during prolonged CNS drug exposure? (ch 20) | increased therapeutic effects, decreased side effects, tolerance, physical dependence
🗑
|
||||
| What type of disorder is Parkinson's Disease? (ch 21) | slowly progressive neurodegenerative disease
🗑
|
||||
| What is the most common degenerative disease of neurons? (ch 21) | Alzheimer's Disease
🗑
|
||||
| What is the second most common degenerative disease of neurons? (ch 21) | Parkinson's Disease
🗑
|
||||
| What are cardinal motor symptoms of Parkinson's Disease? (ch 21) | tremor, rigidity, postural instability, slowed movement
🗑
|
||||
| What are common nonmotor symptoms of Parkinson's Disease? (ch 21) | autonomic disturbances, sleep disturbances, depression, psychosis, dementia
🗑
|
||||
| What are early symptoms of Parkinson's disease? (ch 21) | loss of smell, excessive salivation, clumsiness of the hands, worsening of handwriting, bothersome tremor, slower gait, reduced voice volume
🗑
|
||||
| What is the underlying cause of motor symptoms in Parkinson's Disease? (ch 21) | loss of dopaminergic neurons in the substantial nigra
🗑
|
||||
| What is the most effective drug for Parkinson's Disease? (ch 21) | Levidopa, given in combination with Carbidopa (eventually becomes ineffective)
🗑
|
||||
| Motor symptoms in PD result from damage to what system? (ch 21) | Motor symptoms result from damage to the extrapyramidal system, a complex neuronal network that helps regulate movement
🗑
|
||||
| What are dyskinesias? (ch 21) | Dyskinesia = disorder of movement
🗑
|
||||
| What dyskinesias characterize PD? (ch 21) | tremor at rest, postural instability, bradykinesia
🗑
|
||||
| What is bradykinesia? (ch 21) | slowed movement
🗑
|
||||
| What contributes to the motor symptoms that characterize PD? (ch 21) | overactivity of GABAergic neurons (excitatory influence of ACh that goes unopposed b/c degeneration of neurons in substantia negra that supply dopamine to striatum)
🗑
|
||||
| How many neurons (that supply dopamine to striatum) must be lost before PD becomes clinically recognizable? (ch 21) | 70-80%
🗑
|
||||
| Levidopa - Adverse Effects (ch 21) | nausea & vomiting, dyskinesias (give amantadine?), postural hypotension, psychosis (clozapine, quetapine), anxiety, agitation, memory & cognitive impairment, nightmares, darken sweat and urine
🗑
|
||||
| Levidopa - Drug Interactions (ch 21) | First Gen Antipsychotic Drugs- decrease effects, MAO Inhibitors -> hypertensive crisis, Anticholinergics- enhance response to levodopa
🗑
|
||||
| Levodopa - Food interactions (ch 21) | high-protein meals can reduce therapeutic responses to levodopa (spread protein throughout the day)
🗑
|
||||
| contraindication for Levidopa (ch 21) | malignant melenoma
🗑
|
||||
| What is the action of carbidopa? (ch 21) | Carbidopa prevents decarboxylation of levodopa in intestine and PNS- preserves levodopa so more can cross the BBB
🗑
|
||||
| Pramipexole (ch 21) | DA receptor agonist, will not convert outside brain, doesn't need help, protein okay. *improves motor, good for restless leg
🗑
|
||||
| Pramipexole - adverse effects? (ch 21) | daytime somnolence, hallucinations, self-rewarding behaviors
🗑
|
||||
| Apomorphine (ch 21) | rescue treatment not given by mouth (acute tx fro trough)
🗑
|
||||
| Entracapone (ch 21) | COMT inhibitor used with levodopa, inhibits metabolism of levodopa before brain. can cause yellow/orange urine
🗑
|
||||
| Selegiline (ch 21) | MAO-B inhibitor used with levodopa, benefit decreases after 1-2 yr
🗑
|
||||
| Anticholinergics with Levodopa (ch 21) | reduce tremors but not bradykinesia, better for younger, not old.
*potentially inappropriate for use in geriatric patients (benztropine, trihexyphenidyl)
🗑
|
||||
| Disease characterized by progressive memory loss, impaired thinking, neuropsychiatric symptoms, inability to perform routine activities of daily living (ch 22) | Alzheimer's disease
🗑
|
||||
| Where does neuronal degenerations start in early Alzheimer's Disease? (ch 22) | hippocampus (memory), cerebral cortex (speech, perception, reasoning)
🗑
|
||||
| What are acetylcholine levels like for Alzheimer's patients? (ch 22) | 90% below normal
🗑
|
||||
| neuritic plaques in Parkinson's Disease (ch 21) | Lewy bodies
🗑
|
||||
| neuritic plaques in Alzheimer's Disease (ch 22) | beta-amyloid, + neurofibrillary tabgles (tau twists)
🗑
|
||||
| risk factors for Alzheimer's (ch 22) | age, 90% 65 or older
🗑
|
||||
| Cholinesterase Inhibitors (ch 22) | donepezil, galantamine, rivastigmine approved for tx Alzheimer's
🗑
|
||||
| Donepezil, Galantamine, Rivastigmine (ch 22) | cholinesterase inhibitors approved for tx of Alzheimer's, increase availability of ACh, tx benefits 1 in 12, s/e nausea, vomiting, dyspepsia, diarrhea, dizziness, headache, bronchoconstriction *caution with COPD, can cause bradycardia
🗑
|
||||
| Cholinesterase Inhibitors- interactions (ch 22) | first gen antihistamines, tricyclic antidepressants, conventional antipsychotics
🗑
|
||||
| Memantine (ch 22) | NMDA receptor antagonist for moderate to severe Alzheimer's Disease, dizziness, headache, confusion, constipation
🗑
|
||||
| What kind of disorder is multiple sclerosis? (ch 23) | chronic, inflammatory, autoimune disorder that damages myelin sheath of neurons in the CNS, causing a wide variety of sensory, motor, and cognitive defects
🗑
|
||||
| What are paresthesias? (ch 23) | numbness, tingling, pins & needles
🗑
|
||||
| What are 4 types of MS? (ch 23) | relapsing-remitting (90%), secondary progressive, primary progressive, progressive-relapsing
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
cskrivanek
Popular Nursing sets