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ANTI-PARKINSONIAN DRUGS (EXAMPLES (DOPAMINERGIC AGENTS) (Amantadine…
ANTI-PARKINSONIAN DRUGS
DOPAMINERGIC AGENTS
INDICATIONS
- Levodopa is the drug of choice and acts as a replacement therapy.
- Amantadine is an antiviral drug that increases release of dopamine
- Relief of the signs and symptopms of idiopathic Parkinson’s disease.
- Apomorphine directly binds with postsynaptic dopamine receptors
NURSING CONSIDERATIONS
STORAGE CONDITIONS
- Store away from sunlight and moisture
- Store in a cool dry place
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CONTRA- INDICATIONS
- Suspicious skin lesions. Levodopa is associated with development of melanoma
- Hepatorenal diseases. Can interfere with metabolism and excretion of drug
- Apomorphine can increase risk of hypotension
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SIDE EFFECTS
- GI: anorexia, nausea, vomiting, dysphagia, constipation or diarrhea
- Respiratory: bizarre breathing patterns
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- Flushing, increased sweating, hot flashes
- Cardiovascular : arrhythmias, hypotension, palpitation
MECHANISM OF ACTION
- Levodopa crosses the blood-brain barrier and is converted into dopamine
- A combination of levodopa and carbidopa , leads to higher levels of levodopa that can cross the blood-brain barrier.
ANTICHOLINERGIC AGENTS
INDICATIONS
- Indicated for patients who no longer respond to levodopa
- Adjunctive therapy for Parkinson’s disease
NURSING CONSIDERATIONS
SIDE EFFECTS
- GU: urinary retention and hesitancy
- GI: dry mouth, nausea, vomiting, paralytic ileus, constipation
- Blurred vision, photophobia, pupil dilation, blocking of lens accommodation
- Flushing, reduced sweating
- CNS: disorientation, confusion, memory loss, agitation, nervousness, delirium, dizziness, light-headedness, weakness
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CONTRA-INDICATIONS
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- Tachycardia, dysrhythmia, hyper or hypotension.
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- Lactation. Can enter breast milk and cause adverse effects to the
STORAGE CONDITIONS
- Store away from sunlight and moisture
- Store in a cool dry place
MECHANISM OF ACTION
- reduces the severity of rigidity, akinesia, and tremors
- Peripheral anticholinergics reduce drooling and other secondary effects of parkinsonism.
- Returns the balance to the basal ganglia
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