chapter 31 anti-parkinson agents. copyright 2007 thomson delmar learning, a division of thomson...
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Chapter 31
Anti-Parkinson Agents
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
31 - 2
Parkinson’s Disease
A neurological disorder characterized by:
Muscle tremors Muscle rigidity Lack of coordination Drooling Shuffling gait Postural changes
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Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
31 - 3
Parkinson’s Disease
Imbalance of dopamine and acetylcholine levels in the brain
Levels of other neurological chemical decrease:
Gamma-aminobutyric acid (GABA) Serotonin Norepinephrine
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Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
31 - 4
Classes of Anti-Parkinson Agents
Dopaminergic agents Anticholinergic agents Catechol-O-methyltransferase inhibitors
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Levodopa
Dopaminergic agent Most effective drug treatment Acts peripherally Rapidly converts to dopamine Symptoms subside or disappear
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Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
31 - 6
Levodopa
Therapeutic effects Therapeutic intensity varies Dosage dependent
Adverse effects Nausea and vomiting Orthostatic hypotension Cardiac arrhythmias
(continued)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
31 - 7
Carbidopa/Levodopa (Sinemet)
Carbidopa prevents levodopa from being broken down in the peripheral circulation
Improves neurological-skeletal muscle activity
Combining these agents reduces the required Levodopa dose by 25%
Given in Carbidopa, 10 mg / Levodopa,100 mg dose
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
31 - 8
Amantadine (Symmetrel)
Treats viral disorders such as influenza Acts as an anti-Parkinson agent; it
exerts an additive effect on Levodopa Increases CNS dopamine concentration
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
31 - 9
Anticholinergic Agents
Reduces excessive cholinergic brain activity
Example: trihexyphenidyl (Artane) Used for clients with minimal symptoms Adjunct with other agents
• Caution: narrow-angle glaucoma
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Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
31 - 10
Anticholinergic Agents
Apomorphine (Apokyn) Morphine-like substance
Old, but new No analgesic or addictive qualities Increases dopamine activity
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Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
31 - 11
Newest class of anti-Parkinson drug agents
Treats clients with history of poor response to levodopa
Sustains dopaminergic levels Brain remains stimulated
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Catechol-O-Methyltransferase
Inhibitors
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
31 - 12
Catechol-O-Methyltransferase
Inhibitors Adverse effects Liver failure Dyskinesia Orthostatic hypotension Dystonia Somnolence GI irritation
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