chapter 10 new

What constitutes the central nervous system (CNS)?

Brain and spinal cord

What is a neurotransmitter?

A chemical that transmits signals between nerves.

Name three excitatory neurotransmitters.

Acetylcholine, epinephrine, norepinephrine.

Name three inhibitory neurotransmitters.

Dopamine, serotonin, GABA.

What balance is needed for smooth movement?

Balance of ACh and dopamine.

What causes Parkinson’s disease?

Low dopamine.

What are the key symptoms of Parkinson’s disease?

Tremor, rigidity, bradykinesia, shuffling gait.

What are the three drug classes used for Parkinson’s disease?

Dopamine agonists, COMT inhibitors, MAO-B inhibitors.

What is the most important drug for treating Parkinson’s disease?

Carbidopa/levodopa.

What action does levodopa have?

Converts to dopamine in the brain.

What is the purpose of carbidopa in Parkinson's treatment?

Increases levodopa effectiveness and reduces side effects.

When should dopamine drugs be taken?

30–60 minutes before meals.

What decreases levodopa absorption?

High-protein foods.

What is the 'on/off effect' in Parkinson’s medication?

The drug suddenly stops working.

What are common side effects of dopamine agonists?

Hypotension, nausea, insomnia, confusion.

What is dyskinesia?

Uncontrolled dance-like movements.

What serious mental effects can occur from dopamine agonists?

Hallucinations, delusions.

What safety teaching should be emphasized for Parkinson's patients?

Rise slowly to prevent falls.

Name two examples of COMT inhibitors.

Entacapone, tolcapone.

What action do COMT inhibitors perform?

Prolong dopamine effects.

What is a common harmless side effect of COMT inhibitors?

Orange-brown urine.

What serious adverse effect is associated with tolcapone?

Liver failure.

Name two examples of MAO-B inhibitors.

Selegiline, rasagiline, safinamide.

What action do MAO-B inhibitors perform?

Prevent dopamine breakdown.

What is the major risk associated with MAO-B inhibitors?

Hypertensive crisis.

What causes hypertensive crisis when taking MAO-B inhibitors?

Tyramine foods.

Name some tyramine foods.

Aged cheese, wine, beer, smoked meats.

What is the cause of Alzheimer’s disease?

Decreased acetylcholine.

What is the main symptom of Alzheimer’s disease?

Memory loss.

What are the brain changes associated with Alzheimer’s disease?

Plaques, tangles, neuron damage.

Name three examples of cholinesterase inhibitors.

Donepezil, rivastigmine, galantamine.

What action do cholinesterase inhibitors perform?

Increase acetylcholine.

When should donepezil be taken?

At bedtime.

What are common side effects of cholinesterase inhibitors?

Diarrhea, nausea, headache.

What are parasympathetic effects of cholinesterase inhibitors?

Bradycardia, hypotension, bronchospasm.

What drug is known as an NMDA blocker?

Memantine.

What action does memantine perform?

Blocks calcium entry into neurons.

What are common side effects of memantine?

Headache, dizziness, constipation.

What is epilepsy?

Chronic seizure disorder.

What is a seizure?

Abnormal electrical activity in the brain.

What is a convulsion?

Visible muscle contractions.

What is the purpose of antiepileptic drugs (AEDs)?

Prevent seizures.

Name some traditional antiepileptic drugs (AEDs).

Phenytoin, carbamazepine, ethosuximide, phenobarbital, valproic acid.

What is the most important rule regarding AEDs?

Never stop AEDs suddenly.

What mental health risk is associated with AEDs?

Depression, suicidal thoughts.

What is a side effect of phenytoin?

Gum hyperplasia.

What is a serious reaction associated with phenytoin?

Stevens-Johnson syndrome.

What risk is associated with carbamazepine?

Bone marrow suppression.

What risk is related to phenobarbital?

CNS depression and dependency.

What risk comes with valproic acid?

Liver toxicity.

What are some newer AEDs?

Oxcarbazepine, lamotrigine, lacosamide, topiramate.

What danger is associated with lamotrigine?

Rash = STOP immediately.

What danger is associated with topiramate?

High ammonia = encephalopathy.

What risk is associated with oxcarbazepine?

Hyponatremia.

What risk pertains to lacosamide?

Orthostatic hypotension.

What does MS stand for?

Multiple Sclerosis.

What is MS characterized by?

Autoimmune destruction of myelin.

List some symptoms of MS.

Weakness, vision problems, numbness.

What are the three categories of MS drugs?

BRMs, monoclonal antibodies, neurologic drugs.

What do BRMs do?

Modify immune response.

What are risks associated with monoclonal antibodies?

Infection and allergic reactions.

What drug improves walking in MS patients?

Dalfampridine.

What causes low dopamine in Parkinson's disease?

Parkinson’s disease.

What causes low acetylcholine in Alzheimer's disease?

Alzheimer’s disease.

What happens when MAO inhibitors are combined with tyramine?

Hypertensive crisis.

What should be done if a lamotrigine rash develops?

Stop immediately.

What is the rule regarding AEDs?

Never stop suddenly.