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 2nd most common neurodegenerative disorder?
What are some Nursing Implications in Administration of drugs for Parkinson’s disease?
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 are major SE’s for Sinimet (Parkinson’s)?
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