Parkinson's/MS/Epilepsy Drug Info Cards

Nursing Pharmacology with Burnitt at Goldfarb School of Nursing

About this deck

By: Anonymous
Textbook:

Pharmacology and the Nursing Process
Created: 2011-06-18
Size: 27 flashcards
Views: 23

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What is the Therapeutic goal for Parkinson’s Disease?

To improve the activities of daily living

b/c we can’t cure, can only decease symptoms

What are the symptoms of Parkinson’s Disease?

Motor symptoms resulting from damage to extrapryamidal sys EPS (brain)

Dyskineasia (rest tremors & rigidity)

Bradykineasia (slow shuffle & stooped)

Akinesia (Absence of movement – no expression)

What is the most and 2^nd most common neurodegenerative disorder?

Alzheimer’s

Parkinson’s

What are some Nursing Implications in Administration of drugs for Parkinson’s disease?

1) Stress impt of reg dosing/drug has quick “on-off” effect/symptoms will abruptly return w skipped or missed doses.

2) Take w sm amts of food to avoid nausea, not hi protein b/c will compete w levadopa to cross BBB.

What types of drugs are given for Parkinson’s Disease & what is the best drug?

Dopaminergic – promote activ dop receptors (levadopa)

Anticholinergic – prevent activ cholinergic receptors (benztropine). Don’t use b/c poor Pt adherence b/c of SE’s.

BEST – Sinemet (combo levadopa & carbidopa)

Why is the combo of levadopa & carbidopa better than levadopa alone?

B/c carbidopa prevents peripheral metabolism of levadopa & allows it to cross the BBB. Carbidopa has no benefits of its own.

How are drug selection and dosages determined in Parkinson’s patients?

By activities of daily living performance

What is the Pathophysiology of Multiple Sclerosis?

Autoimmune in nature
Inflammation & myeline sheath destruction in the CNS

What are the signs & symptoms of MS?

Paresthesais (tingling)
Weakness
Numbness
Depression

What are the 4 subtypes of MS?

Primary progressive (Symp progressively ↑ intense, no clear remissions)

Secondary progressive (Relap/Remit, ↓ func)
Progressive-relapsing (rare, acute exacerbat on Prim Prog)

Relapsing-remitting (def episodes separated by periods partial/full recovery)

What therapies are used to treat MS (the disease)?

Interferons (possible)
High-dose glucocorticoids (methylprednisolone)

List the therapies for Depression, Fatigue & Neuropatic pain in MS Pts?

Depression - Antidepressants
Fatigue - Methylphenidate (Ritalin) & Modafinil (Provigil)
Neuropathic pain (Burning, numbness & tingling) - AED drugs (tegretol, gabapentin)

What is the Pathophys of Epilepsy?

Excessive excitability of neurons in the CNS

What are the 7 different types of seizures?

*Partial *Tonic-Clonic (Grand Mal)
*Absence (Petit Mal) *Atonic (Drop Attack)
*Myclonic (Sud isolated musc contrac)
*Status epilepticus (more than 30 mins; in ER)
*Febrile

Describe "Partial seizure"?

Discrete symptoms determined by the region of brain involved. Ex.

Motor - Thumb twitch
Sensory - numbness/olfactory hallucination
Autonomic - nausea, flushing, salivation

Describe "Febrile seizure"?

Common in 6 mos to 5 yrs; A result of children having fevers
Does NOT put them at high risk for developing epilepsy later on
Nurse Implications - Explain its frightening, but not hi risk, protect when happens

What is the Goal of Therapy for Epilepsy Pts?

↓ seizures to an extent that enables normal or near-normal life
Ideal - eliminate seizures, but might not be possible b/c of drug SEs

What are some Nursing Implications for AEDs?

*Monitor Plasma drug levels - TI estab
*Promote Pt adherence *Spontaneous remission could occur
*Potential for suicidal ideations - contact nurse to adjust dosage
*Withdrawal AEDs see separate slide w info

Describe the proper way to withdrawal AEDs to prevent redevelopment of seizure disorder?

Must be done slowly (over 6-36 weeks)
If on more than 1 agent, withdrawal individually

Must keep a seizure diary

What is the traditional AEDs?

Phenytoin (Dilantin, Phenytek)
Target Serum levels are 10-20 mcg/mL
Most widely used AED

What are the Adverse Effects of Phenytoin?

Few - Phenytoin is relatively selective
Sedation - higher doses
Gengival Hyperplasia (Gums grow big & fat)
Teratogenic effects of Cleft Palate & Heart Malformations

What are the teratogenic effects of Phenytoin (Epilepsy)

Cleft Palate
Heart Malformations

List other AEDs besides Phenytoin, what else they may be used to treat & adverse or side effects

Carbamazepine (Tegretol) - similar to Phenytoin

Valproic Acid (Depakote) - Bipolar/Migraine. Gen well tolerated. Teratogenic=neural tube defects
Phenobarbital - Oldest AED. Cheap,effective,1/day dosing. Maj SE=CNS depression (drowsiness/sedation) Terat

How do you manage Epilepsy in pregnant women?

Challenging!! ALL AEDs can harm fetus; most risk during 1^st trimester
Seizure more harmful to baby than teratogenic effects. To ↓ AED teratogenic effects: *↓ to 1 AED med *Use lowest effective dose *Sup folic acid (2mg/day; 5x usual dose)

What are major SE’s for Sinimet (Parkinson’s)?

Postural hypotension

Dyskineasia (Head bob, tick)

Nausea & Vomitting

Dysrhythmias (not rate, but rhythm)

Psych disturbances (Depression/Hallucinations)

List the major drug interactions for Sinemet (Parkinson’s)?

MAOI – cause hypertensive crisis (MI/stroke)

Anticholinergics – decrease effectiveness of Sinemet

Antipsychotics – decrease effectiveness of Sinemet

What is the major contraindication for Sinemet?

Malignant Melanoma – activates the neoplasm

About this deck

By: Anonymous
Textbook:

Pharmacology and the Nursing Process
Created: 2011-06-18
Size: 27 flashcards
Views: 23

About StudyBlue

“I have used this website for three exams, and I see a huge difference in my test results.”
Naj