Antiparkinsons Drugs
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- What are 2 factors that help decide which drugs to use for Parkinson's patients?
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1)severity of disease
2)ability to tolerate side effects - In Parkinson's, what happens to dopamine and cholinergic levels in the body?
- There is decreased dopaminergic activity and increased cholinergic activity.
- what are 3 therapeutic strategies for treating Parkinson's?
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1) increase dopamine concentration and receptor activity
2) inhibit the metabolism/breakdown of dopamine
3) anticholinergic drugs (reduce cholingergic activity, as an adjunctive therapy - In Parkinson's, can use of drugs eliminate or cure the disease?
- NO! drugs can reduce symptoms and improve condition, but cannot fix the problem
- what is the name of the drug used in PK that is a metabolic precursor of dopamine?
- Levodopa
- what drug used in PK is a dopamine agonist?
- bromocriptine (parlodel)
- what drug for PK inhibits metabolism of dopamine?
- selegiline (eldepryl)
- what drug used in PK is an anticholinergic?
- benztropine (cogentin)
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an example of a monoamine oxidase inhibitor is:
-benztropine
-selegiline
-bromocriptine - selegiline
- what should you know about benztropine?
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-used as an adjunct drug in Parkinsons and in drug induced extra-pyramidal disorders (as caused by antipsychotics)
-alleviate tremors and rigidity
-causes mood changes, dry mouth, blurred vision, constipation, and urinary retention -
what should you know about selegiline?
(effects, uses) -
-used as adjunct therapy with levodopa/carbidopa
-use for slow progression of disease
-causes nausea, dizziness, lightheadedness, abdom. pain, dry mouth, headache, vivid dreams and hallucinations - what should you know about bromocriptine (effects)?
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-used with Levodopa
-no effect on pts. who do not respond ot levodopa
-similar side effects to levodopa, except lesson common dyskinesia
-causes hallucinations, confusion, delirium, nausea, ortho. hypotension - what are the main effects (therapeutic and side) for levodopa?
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-decrease rigidity and tremors
-tolerance from long term use
-on-off phenomenon
-psychological disorders
-nausea, vomiting, anorexia, tachycardia, post. hypotension
-mydriasis
-dykinesia - what is carbidopa used in conjunction with?
- it is used with levodopa, it inhibits the metabolism of levodopa in the GI tract and peripheral tissues
- as OTs, what should we think about with PK pts.?
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-work on gait training and balance activities
-help pt. keep function to eliminate need for more drugs
-maintain joint ROM and cardio fitness during drug holidays - Which drug for PK might a pt. take a drug holiday?
- Levodopa, because tolerance can develop with long term use
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bradykinesia, postural/gait abnormalities, tremors, and muscular rigidity
These are characteristics of what? - Parkinson's Disease
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Which is not a sign of Parkinson's?
-impaired speech
-cognitive delays
-shuffling gait
-blank facial expression
-inability to perform skilled tasks - cognitive delays