McKenna's Pharmacology for Nursing, 2e

24

Antiparkinsonism agents

Learning objectives Upon completion of this chapter, you should be able to: 1. Describe the current theory of the cause of Parkinson’s disease and correlate this with the clinical presentation of the disease. 2. Describe the therapeutic actions, indications, pharmacokinetics, contraindications, most common adverse reactions and important drug–drug interactions associated with antiparkinsonism agents. 3. Discuss the use of antiparkinsonism agents across the lifespan. 4. Compare and contrast the prototype drugs for each class of antiparkinsonism agents with the other drugs in that class and with drugs from the other classes that are used to treat the disease. 5. Outline the care considerations and teaching needs for people receiving each class of antiparkinsonism agents.

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Glossary of key terms anticholinergic: drug that opposes the effects of acetylcholine at acetylcholine-receptor sites bradykinesia: difficulty in performing intentional movements and extreme slowness and sluggishness; characteristic of Parkinson’s disease corpus striatum: part of the brain that reacts with the substantia nigra to maintain a balance of suppression and stimulation dopaminergic: drug that increases the effects of dopamine at receptor sites Parkinson’s disease: debilitating disease, characterised by progressive loss of coordination and function, which results from the degeneration of dopamine-producing cells in the substantia nigra parkinsonism: Parkinson’s disease–like extrapyramidal symptoms that are adverse effects associated with particular drugs or brain injuries substantia nigra: a part of the brain rich in dopamine and dopamine receptors; site of degenerating neurons in Parkinson’s disease

DOPAMINERGIC AGENTS amantadine apomorphine bromocriptine cabergoline carbidopa–levodopa levodopa

ANTICHOLINERGIC AGENTS benzhexol benztropine biperiden

ADJUNCTIVE AGENTS entacapone

levodopa-benserazide levodopa-carbidopa- entacapone pergolide pramipexole

rasagiline selegiline tolcapone

ropinirole rotigotine