What is the mechanism of action of levodopa?
Dopamine receptor antagonist. Levodopa is converted to dopamine in the basal ganglia.
Why is carbidopa given with levodopa?
Carbidopa decreased the peripheral metabolism of levodopa- can reduce levodopa dosage
What medication class needs to be AVOIDED with Levodopa-Carbidopa (due to hypertensive crisis)?
MAOIs
How does Donepezil work?
Inhibits acetylcholinesterase- enzyme responsible for destruction of neurotransmitter: acetylcholine. Increases acetylcholine slows neuronal degradation.
You are caring for a patient with Alzheimer's disease. They have been on donepezil for 3 months but the family states they have not noticed any improvement. Should the medication be stopped? Why or why not?
Keep taking. Can take 6-12 months for improvement to be noticed. (could be slowing progression)
Delirium is not serious and resolves on it's own. True or False?
FALSE- Medical Emergency. Must find cause and treat before irreversible damage
What class of medication is Memantine (Namenda)?
N-methyl-d-aspartate receptor antagonist (Alzheimer's)
You are working in a SNF and caring for patient's with dementia. What environment is most appropriate?
Quiet, Calm, Display clocks and calendars, Limit environmental stimuli, Talk pleasantly
Donepezil is safe to take with liver failure. True or False
False- metabolized in liver
Memantine is safe to take in renal failure. True or False
False
What are the 4 main clinical signs of Parkinson's Disease?
Tremor, Rigidity, Bradykinesia, Postural Changes
What symptoms may a person experience in the premonitory phase of a migraine headache?
Depression, Irritability, Feeling Cold, Food Cravings, Anorexia, Change in Activity Level, Increased Urination, Diarrhea, Constipation
What symptoms may a person experience during the aura phase of a migraine?
Visual Disturbances: light flashes, bright spots, Numbness/Tingling of lips, face or hands; mild confusion, slight weakness of extremity, drowsiness, dizziness
What symptoms may a person experience during the headache phase of a migraine?
Severe and incapacitating pain; Often associated with photophobia (light sensitivity), phonophobia (sound sensitivity), allodynia (extremely sensitive to touch)
What symptoms may a person experience during the postdrome phase of a migraine?
Pain gradually subsides, Tiredness, weakness, cognitive difficulties, mood changes (hours to days) Muscle contraction in neck and scalp, pain with exertion
What are the 2 main OTC meds for migraine treatment?
Naproxen and Acetaminophen-Aspirin-Caffeine
