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UC NURS 8024 Module 8 Neuro questions with correct answers
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UC NURS 8024 Module 8 Neuro questions with correct answers
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UC NURS 8024 Module 8 Neurodrugs used in Parkinsonism - correct answer ✔✔dopamine precursor (levodopa), dopamine agonists
(bromocriptine, pramipexole), MAOI (selegiline), COMT inhibitors (entacapone), muscarinic antagonists
(benztropine)
amantadine - correct answer ✔✔glutamate antagonist (antiviral), enhances dopaminergic
neurotransmission. Used for minor Parkinson's sx, improves bradykinesia, rigidity, tremor. ADE - dry
mouth, restlessness, agitation, urinary retention, post. hypotension, pedal edema. Caution in seizure
disorders and CHF!
Anticholinergic agents - correct answer ✔✔antimuscarinic, decreases the excitatory actions of
cholinergic neurons by blocking muscarinic repectors. Improves tremor and rigidity but not bradykinesia.
ex: benztropine (Cogentin). Caution in elderly, BPH, urinary retention, liver, renal or GI or GU disease.
Can precipitate narrow angle glaucoma. Limited use d/t ADEs
dopamine receptor agonists - correct answer ✔✔effective mild parkinsonism, used in combo with
levodopa. also for restless leg syndrome. ex: pramipexole (Mirapex). ADE - N/V, anorexia, dyskinesias,
CNS - confusion, delusions, hallucinations (more common with levodopa). Monitor - renal function
pramipexole (Mirapex) - correct answer ✔✔dopamine receptor agonist, often combined with levodopa.
ADE - N/V, anorexia, dyskinesias, CNS - confusion, delusions, hallucinations (more common with
levodopa). Monitor - renal function
ropinirole hydrocholoride (Requip) - correct answer ✔✔dopamine receptor agonist. effective for mild
parkinsonism, also used in combo with levodopa, and in restless leg syndrome.
ADE - N/V, anorexia, dyskinesias, CNS - confusion, delusions, hallucinations (more common with
levodopa). Monitor - renal function
monamine oxidase B inhibitors - correct answer ✔✔MOA not fully understood. ex: selegiline (Eldepryl),
rasagiline (Azilect). used in early Parkinson's disease, mild sx, usually given with levodopa. No tyramine
foods! ADE - insomnia, mood changes, dyskinesias, GI sx, hypotension. Do not combine with fluoxetine
or meperidine - additive effect!
, Dopamine precursors - correct answer ✔✔enhances synthesis of dopamine. levodopa and carbidopa
(Sinemet). works best in new patients. over time, number of neurons decreases. relief lasts only while
drug is present in body. Give levodopa in combination with carbidopa to increase levadopa availability
Levadopa - correct answer ✔✔dopamine precursor. attempts to replace dopamine. Can cross BBB. rapid
GI absorption, short half life. On-off phenomenon - sudden loss of normal mobility, tremors. Take
levodopa on empty stomach to increase CNS availability - meals (esp high protein) interferes with
levodopa transport in CNS
carbidopa - correct answer ✔✔dopamine precursor. enhances effect of levadopa by diminishing
metabolism of levadopa in GI tract and peripheral tissues. Increases availability of levadopa to cross into
CNS.
levodopa/carbidopa combination - correct answer ✔✔potent and effective in treatment. carbidopa
increases bioavailability of levodopa - more CNS availability. levodopa decreases rigidity and tremors.
typical decline in response in 3rd to 5th year of tx.
levodopa ADEs - correct answer ✔✔GI sx, tachycardia, PVCs, postural hypotension, mydriasis (can
precipitate glaucoma). CNS effects: hallucinations, dyskinesias, mood changes, depression, psychosis,
anxiety. CI in hx of psychosis
COMT inhibitors - correct answer ✔✔Catechol-O-Methyltransferase (COMT) inhibitor. Adjunctive
therapy with levodopa-carbidopa. increases concentration of dopamine in CNS. ex: Entacapone
(Comtan). ADE (secondary to inc. levadopa): dyskinesias, GI distress, postural hypotension. Tolcapone -
increased liver enzymes, acute hepatic failure. **Do not use MAOI and COMT together
distinguishing features of Alzheimer's - correct answer ✔✔accumulation of senile plaques (beta-
amyloid), formation of neurofibrillary tangles, loss of cortical neurons -particularly cholinergic neurons
cholinesterase inhibitors - correct answer ✔✔management of mild to moderate Alzheimer's. MOA -
block enzyme that degrades ACh, enhances cholinergic transmission. ADE - GI sx, insomnia, fatigue,
cramps, anorexia. ex: donepezil (Aricept), rivastigmine (Exelon), galantamine (Razadyne)
NMDA receptor antagonists - correct answer ✔✔Decreases activity of glutamate in synapse,
neuroprotective. mod-severe Alzheimer's. often given in addition to cholinesterase inhibitors. ex:
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