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24 Cards in this Set

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Parkinsons disease is a problem in what part of the CNS?
Alzhimers disease is a problem in what part of the CNS?
Park- Basal ganglia

Alz- Limbic system
What happens pathologically to you that causes Alzheimer's disease?
Pathology
Neurons lose their dendrites
Plaques develop between cells
Acetylcholine and serotonin decrease by as much as 50%
WHat are the goals and drugs for Alzheimer's disease?
Goals: improve ADLs, Behavior, Cognition.
Acetylcholinesterase Inhibitors :
Donepezil (Aricept)
Galantamine (Reminyl)
What drugs treat Alzheimer's disease?
Donepezil (Aricept)
Galantamine (Reminyl)
How long does Donepzil (aricept) take to work?
3 weeks
What drugs are approved for severe dementia in alz?
Memantine (NAMENDA)
What are some of the symptoms of Parkinsons?
Tremor
Muscle rigidity
Stooped posture
Shuffling gait
Drooling
Difficulty swallowing
Explain some of the pathophisology of parkinsons?
It is an imbalance in dopamine and Ach. There is too much Ach and too little dopamine.
What is the goal of treatment and the different types of drugs used for it(drug categories)?
Aim is to restore dopamine levels or dopamine activity in the brain by using:
Dopamine precursors
Dopamine agonists
MAO inhibitors
Anticholinergics
Can exogonous dopamine cross the BBB?
No a precurser is needed such as levodopa
What are some important pt. teaching when dealing with levodopa?
Do not abruptly discontinue – may cause neuroleptic malignant syndrome (NMS)
Limit protein and pyridoxine
Full therapeutic effect may take months
Does carbidopa cross the BBB?
No, but levodopa does.
How long does Carbidopa-levodopa (SINEMET) take to work?
2-3 weeks
What is some info on Amantadine (Symmetrel)?
-stimulates relase of dopamine
-anti viral agent
-early parkinsons
-only effective for 6-12 months
What are some adverse effects of Amantadine (Symmetrel)?
CNS effects
Anticholinergic effects
Insomnia
Livedo reticularis – reddish-blue netlike mottling of skin
What is some info on Selegiline (ELDYPRYL)?
Aducative with levodopa

Use caution with high doses and tyramine-containing foods
Do not exceed dose of 10mg/day to maintain MAO-B selectivity
What are some adverse effects of Selegiline (ELDYPRYL)?
Nausea, abdominal pain
Dry mouth, insomnia, confusion, dizziness
What is Rasagiline (AZILECT)?
MAOI
Aduvtive with levodopa
AVOID tyramine-rich foods and beverages (cheese and red wine)
CAUTION with dietary supplements or amines in cough and cold medications
What do Pergolide and Bromocriptine do?
Often given with levodopa-carbidopa to lower need for levodopa
Prolongs the “on” period
What does Mirapex treat?
Early and late stage parkinsons
What do you have to know about Rotigotine (NEUPRO)?
A patch that treats PD, change daily.
What is Ropinirole (REQUIP) and what does it do?
treates PD, works with mono or adjuctive with levodopa.
What is a COMT inhibitor?
COMT breaks down dopamine in the perriphery, COMT inhibotors keep more dopamine in the peripher and reduce sighns and symptoms.
They must be given with carbid levodopa.
indicated when other aductive thearapies arenet working.
WHat are Cogentin and Artane?
central acting anti colanergics.