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Anti-Parkinsonism Agents

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Pt’s w/Parkinsons disease exhibit——– marked for difficulties in performing intentional movement and extreme sluggishness
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Bradykinesia
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In Parkinson’s disease, nerve cells begin to which degenerated in the dopamine rich area of the brain is called——–
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Substania Nigra
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Dopaminergics Agents
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amantadine levedopa ropinirole
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Anticholinergics
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benztropine biperden diphenhydramine
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Adjunctive Agents
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entacapone selegiline
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When describing the action of levodopa, which of the following would the nurse include? a. acts like replacement therapy b. increases the release of dopamine c. binds directly w/postsynatic dopamine receptors d. stimulates dopamine receptors
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a. acts like replacement therapy
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A Pt asks nurse why he must take his levodopa in combination with carbidopa. Which response by nurse would be appropriate? a. “the carbidopa helps the levodopa get in to the brain” b. “the carbidopa allows a lower dose of levodopa to be used.” c. “it boosts the action of levodopa to prevent the nerve cells from degenerating” d. “the carbidopa prevents too much levodopa from being excreted”
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b. “the carbidopa allows a lower dose of levodopa to be used.”
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A Pt is to receive apomorphine as treatment for Parkinson’s disease. The nurse would expect to administer this drug by which route? a. oral b. topical c. subcutaneous d. intramuscular
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c. subcutaneous
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When reviewing a Pt’s history, which of the following would the nurse identify as a contraindication to the use of levodopa? a. mycardial infarctions b. bronchial asthma c. peptic ulcer disease d. suspicious skin lesions
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d. suspicious skin lesions Because levodopa is associated with development of melanoma. Use with caution with the other conditions
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Which of the following would a nurse expect to assess as potential adverse effect of dopaminergic therapy? a. sedation b. muscle flaccidity c. nervousness d. hypertension
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c. nervousness Because of stimulation of dopamine receptors also may include anxiety, confusion, mental changes, muscle twitching, ataxia and hypotension
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Which of the following would a nurse identify as lease likely to contribute to a decrease in effectiveness of levodopa? a. pyridoxine b. phenytoin c. multivitamin supplement d. St. Johns wort
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d. St. Johns wort St Johns may lead to hypertensive crisis if given with rasagiline not levodopa.
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A Pt is to receive trihexyphenidyl as adjunctive treatment for Parkinson’s disease. The nurse would expect to administer this drug by which route? a. oral b. subcutaneous c. intramuscular d. intravenous
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a. oral
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A nurse is reviewing a Pt’s history for conditions that would contraindicate the use of anticholinergics for Parkinson’s disease. Which of the following would cause the nurse to be concerned? a. hypertension b. myasthenia gravis c. hypatic dysfunction d. cardiac arrhythmia
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b. myasthenia gravis
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Which of the following would lead the nurse to suspect that a Pt is experiencing an adverse effects to an anticholinergic agents? a. diarrhea b. diaphoresis c. excess salvation d. agitation
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d. agitation Would be noted due to blocking of central acetylcholine receptors
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After reviewing the drugs used to treat Parkinson’s disease, the students demonstrate understanding when they identify which of the following as dopaminergice agent? a. diphenhydramine b. biperiden c. bromocriptine d. tolapone
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c. bromocriptine biperiden is anticholinergic
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A Pt who is receiving biperiden complains of light headedness, dizziness and blurred vision. Which nursing Dx would be most appropriate? a. risk for impaired thermoregulation b. disturbed thought process c. deficient knowledge d. risk for injury
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d. risk for injury
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When administering entacapone, the nurse understands that this drug affects which enzyme? a. lactic dehyrogenase b. catecholamine- O – methyl transferase c. monoamine oxidase d. acetylcholinesterase
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b. catecholamine- O – methyl transferase
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Which action would be a priority for a Pt receiving apomorphine? a. giving the drug w/food b. monitoring cardiac status c. checking for skin lesions d. palpating the bladder
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b. monitoring cardiac status
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A Pt is experiencing parkinsonism as a result of drug therapy w/ a phenothiazine. The nurse would anticipate which agent as being prescribed? a. bromocriptine b. pramipexole c. biperiden d. selegiline
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c. biperiden Indicated for treatment of parkinsonism
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Which of the following would be considered a peripheral anticholinergic effect of anticholinergic drug therapy? a. delirium b. blurred vision c. agitation d. memory loss
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b. blurred vision Is a sign of peripheral anticholinergic effects, the others are CNS effects
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Parkinsons is progressive, chronic neurological disorder that is usually? a. associated w/severe head injury b. associated w/chronic diseases c. associated w/old age d. known to affect people of all ages w/no known cause
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d. known to affect people of all ages w/no known cause
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Parkinsons disease reflects an imbalance between inhibitory and stimulating activity of nerves in the? a. reticular activating system b. cerebellum c. basal ganglia d. limbic system
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c. basal ganglia
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The main underlying problem w/Parkinson’s disease seems to be a decrease in the neurotransmitter? a. acetylcholine b. norepinephrine c. dopamine d. serotonin
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c. dopamine
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Anticholinergic drugs are effective in early Parkinson disease. They act?
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to block stimulating effects of acetylcholine in the brain to bring activity back into balance.
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Pt receiving an anticholinergic drug for Parkinson goes to Tahiti @70degrees warmer than at home. What precautions should Pt be urged to take?
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Reduce dose and take precessions to reduce risk of heat stroke
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Replacing dopamine in the brain would seem to be the best treatment for Parkinson disease. This is difficult because dopamine? a. is broken down in gastric acid b. in not available in drug form c. cannot cross the blood brain barrier d. is used peripherally before reaching the brain
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c. cannot cross the blood brain barrier
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A Pt taking levodopa and over the counter megavitamins might experience? a. cure from parkinson disease b. return of parkinson symptoms c. improved health and well being d. a resistance to viral infections
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b. return of parkinson symptoms
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How can nurse best explain what causes parkinsonism to a Pt?
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adverse effects of drug therapy brain injury viral infections
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No therapy is available that will stop the loss of neurons and eventual decline of function in clients w/parkinson. Nursing care should include?
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-Supportive education as drugs fail and new therapy is needed -Community and family support networking -Explanations of the adjective drug therapy that may be used