Question

Assignments, Chapter 24, Antiparkinsonism Agents Written Assignments Learning Objective(s) 1. Create a table to compare anticholinergics, dopaminergics, and adjunctive therapies used to treat Parkinson's disease. The table should include therapeutic actions, indications, pharmacokinetics, contraindications, the most common adverse reactions, and important drug-drug interactions. 2. You are caring for a 75-year-old patient who takes antiparkinsonism drugs. List special nursing considerations for this patient.

Answer 1

1) Learning objectives

Anticholinergics :-

Action :-

Block the action of acetylcholine in the CNS to help normalize the acetylcholine - dopamine imbalance.

Indications :-

- Treatment of parkinsonism

- Relief of extrapyramidal symptoms

Pharmacokinetics :-

- Absorbed from GI tract

- Peak 1-4 hours

- Metabolized in the liver, excreted by cellular pathways

- Crosses the placenta and enter the breast milk

Contraindication:-

- Narrow angle glaucoma

- GI obstruction

- GU obstruction

- Prostatic hypertrophy

Cautions :-

- Dysrhythmia

- Hypertension

-Hypotension

- Hepatic dysfunctions

- Pregnancy and lactation

Adverse Reactions :-

- Disorientation

- Confusion

- Agitation

- Delirium

- Nausea, vomiting, paralytic ileus

Drug to Drug interaction:-

- Tricyclic antidepressants

- Phenothiazines

Dopaminergics :-

Actions :-

- Inccreasing the levels of dopamine in the substantia nigra.

- Directly stimulating the dopamine receptors in that area.

- Helping to restore the balance between the inhibitory and stimulating neurons.

Indications :-

- Relief of the signs and symptoms of idiopathic Parkinson's disease

Pharmacokinetics :-

- Well absorbed from the GI tract and widely distributed in the body

- Metabolized in the liver and peripheral cells

- Excreted in the urine.

- Crosses the placenta

Contraindications :-

- Known allergy

- Angle closure glaucoma

GI obstruction

Cautions :-

- CV disease

- Bronchial asthma

- H/O peptic ulcers

- Urinary tract obstruction

- Psychiatric disorders.

Adverse Reactions :-

- Anxiety

-Nervousness

- Headache

- Blurred vision

- Arrhythmias

Drug to Drug interactions :-

MAOI' s

Vitamin B6