Question

Client A. G. is an 80 year old make with a diagnosis of both Parkinson's and Alzheimer's diseases.

Consider the pathopharmacological basis for creating a plan of care. (Hint: think about which medications would decrease/increase dopamine and which would decrease/increase levels of acetylcholine. How would those medications affect the underlying disease processes?) You do NOT have to consider which medications you would prescribe or at which doses - that is beyond the scope of this course, but you do have to consider how a nurse would work with an interprofessional health care team AND relate your knowledge of understanding how medications affect these disease processes.

Answer 1

PARKINSON'S DISEASE: is a disorder of the central nervous system that affects movement, often including tremors. It affects cells in the brain that produce dopamine. The symptoms of this diseases includes a) muscle rigidity b) tremors c) change in speech and gait.

ALZHEIMER'S DISEASE: is a progressive disease that destroys memory and other important mental functions. Symptoms usually develop slowly and get worse over time.

PATHOPHARMACOLOGICAL CONSIDERATIONS: People with this disease have low brain dopamine concentrations.

A. LEVODOPA AND CARBIDOPA: it is a medicine commonly used to treat Parkinson's disease. Levodopa is a natural chemical that passes into the brain and is converted into dopamine. Levodopa is combined with Carbidopa, which protects levodopa from early conversion to dopamine outside the brain.

B. DOPAMINE AGONISTS: Its action does not change into dopamine despite, it mimic the dopamine effects in the brain.

C. MONOAMINE OXIDASE B INHIBITORS: its action helps to prevent the breakdown of brain dopamine by inhibiting the brain enzyme MAO B. It metabolizes the dopamine present in the brain. It also neuroprotective agent and also slows the disease progression.

D. CATECHOL O-METHYLTRANSFERASE ( COMT) :It inhibits the levodopa action by blocking an enzyme that breaks down dopamine.

E. AMANTADINE: It blocks the action of neurotransmitter glutamate, which allows for an increase in dopamine release.

F. TRIHEXIPHENIDYL AND BENZTROPNIE: It reduces the activity of the neurotransmitter acetylcholine.