Antiparkinson

As a class, these agents tend to be devoid of antihistaminic activity, while they retain some of the sedative and antiparkinson... 

Introduction of branching in the side chain is apparently consistent with retention of the antiparkinson activity. Bro-mination of propiophenone gives the brominated ketone, 33. Dis-... 

Discuss the uses, general drug action, adverse drug reactions, contraindications, precautions, and interactions of the antiparkinsonism drugs. 

Discuss important preadministration and ongoing assessment activities the nurse should perform on the patient taking antiparkinsonism drugs. 

The dopaminergic drugs are used to treat die signs and symptoms of parkinsonism. As witii some otiier types of drugp, it may be necessary to change from one antiparkinsonism drug to anotiier or to increase or decrease die dosage until maximum response is obtained. 

Amantadine is less effective than levodopa in the treatment of Fhrkinson s disease but more effective than die anticholinergics. Amantadine may be given alone or in combination witii an antiparkinsonism drug witii anticholinergic activity. Amantadine is also used as an antiviral drug (see Chap. 14). 

Chap. 31), and during lactation. Levodopa is used cautiously in patients with cardiovascular disease, bronchial asthma, emphysema, peptic ulcer disease, renal or hepatic disease and psychosis. Levodopa and combination antiparkinsonism drugs (eg, carbidopa/levodopa) are classified as Pregnancy Category C and are used with caution during pregnancy and lactation. 

Frequently seen adverse reactions to dragp with anticholinergic activity include dry mouth, blurred vision, dizziness, mild nausea, and nervousness. These may become less pronounced as therapy progresses. Other adverse reactions may include skin rash, urticaria (hives), urinary retention, dysuria, tachycardia, muscle weakness, disorientation, and confusion. If any of these reactions are severe, the drug may be discontinued for several days and restarted at a lower dosage, or a different antiparkinsonism drag may be prescribed. 

A newer classification of antiparkinson drugs is the catechol-O-methyltransferase (COMT) inhibitors. Examples of the COMT inhibitors are entacapone (Comtan) and tolcapone (Tasmar). 

The dragp used to treat parkinsonism also may be used to treat the symptoms of parkinsonism that occur with the administrafion of some of the psychotherapeutic dragp (see Chap. 32). When used for this purpose, the antiparkinsonism drugp may exacerbate mental symptoms and precipitate a psychosis. The nurse must observe the paHent s behavior at frequent intervals. If sudden behavioral changes are noted, the nurse withholds the next dose of the drug and immediately nofifies the primary health care provider. 

I younger adult receiving the antiparkinsonism drugs especially when taking the dopamine receptor agonists The nurse should assess the older adult for sgns of visual, auditory, or tactile hallucinations The incidence of halludnationsappears to increase with age. 

Do not abruptly discontinue use of the antiparkinsonism drugs Neuroleptic malignant-like syndrome may occur when the antiparkinsonism drugs are discontinued or the dosage of levodopa is reduced abruptly. The nurse carefully observes the patient and reports the following symptoms muscular rigidity, elevated body temperature, and mental changes... 

Extrapyramidal effects usually diminish with a reduction in the dosage of the antipsychotic drug. The primary health care provider may also prescribe an antiparkinsonism drug, such as benztropine (see Chap. 29) to reduce the incidence of Parkinson-like symptoms. 

A patient taking chlorpromazine (Thorazine) for schizophrenia is also prescribed die antiparkinson drug benztropine What is the best explanation for adding an antiparkinson drug to die drug regimen ... 

A. Antiparkinson drugp prevent symptoms of tardive diskinesia, such as involuntary movements of die face and tongue... 

C. Antiparkinson drugp are given to reduce die possibility of symptoms such as fine tremors, muscle rigidity, and slow movement. 

D. Antiparkinson drugp help to decrease hallucinations and delusions in patients witii schizophrenia... 

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