Parkinson's Disease Symptoms, Treatment, Nursing Care, Pathophysiology NCLEX Review
Summary
TLDRThis video provides a comprehensive overview of Parkinson's disease, a movement disorder affecting dopaminergic neurons. It discusses the disease's impact on movement, the role of dopamine, and the imbalance with acetylcholine. The video also covers symptoms, treatments including medications like carbidopa-levodopa, and nursing interventions focusing on safety, psychosocial support, and nutrition.
Takeaways
- π§ Parkinson's disease is a neurological condition that primarily affects movement, characterized by the degeneration of dopaminergic neurons in the substantia nigra.
- π The reduction in dopamine, a neurotransmitter crucial for movement accuracy, leads to the characteristic symptoms of Parkinson's disease.
- π There is an imbalance in the nervous system between acetylcholine, an excitatory neurotransmitter, and dopamine, an inhibitory neurotransmitter, in Parkinson's disease.
- π Medications for Parkinson's disease aim to restore the balance between acetylcholine and dopamine, with anticholinergic medications being a common treatment for younger patients experiencing tremors.
- π΄ Parkinson's disease typically affects older adults, but it can also occur in younger individuals, such as actor Michael J. Fox, who was diagnosed at age 29.
- πΆββοΈ Early signs of Parkinson's disease include subtle tremors, stiffness of extremities, and changes in gait, which can progress to affect the entire body over time.
- π Nursing interventions for Parkinson's disease focus on safety, psychosocial support, digestion and nutrition, and education about medication side effects and management.
- π οΈ Assistive devices like canes, walkers, and handrails, as well as modifications to the home environment, can help improve safety and mobility for patients with Parkinson's disease.
- π½οΈ Dietary considerations for Parkinson's patients include a soft diet, high-fiber intake, and careful management of protein intake to optimize medication effectiveness.
- πͺ Encouraging physical activity and providing support for autonomy in daily living tasks can help maintain quality of life for individuals with Parkinson's disease.
Q & A
What is Parkinson's disease?
-Parkinson's disease is a neurodegenerative disorder that primarily affects movement. It is characterized by the degeneration of dopaminergic neurons in the substantia nigra, leading to a decrease in the neurotransmitter dopamine, which is crucial for movement accuracy.
Why are movements affected in Parkinson's disease?
-Movements are affected because the dopaminergic neurons in the substantia nigra start to die, resulting in less dopamine being produced. Since dopamine is essential for the accuracy of movements, its deficiency leads to various movement-related issues.
What is the role of the substantia nigra in Parkinson's disease?
-The substantia nigra is a part of the basal ganglia in the midbrain that controls movement. In Parkinson's disease, the dopaminergic neurons in this area degenerate, leading to a reduction in dopamine and affecting movement control.
How does the balance between acetylcholine and dopamine relate to Parkinson's disease?
-In Parkinson's disease, the reduction of dopamine leads to an imbalance with acetylcholine, an excitatory neurotransmitter. With less inhibitory dopamine, acetylcholine over-stimulates neurons, causing symptoms like tremors and rigidity.
What is the significance of dopamine agonists in treating Parkinson's disease?
-Dopamine agonists, such as ropinirole, stimulate dopamine receptors and help improve the signs and symptoms of Parkinson's disease by mimicking the effects of dopamine.
Why are anticholinergic medications used in the treatment of Parkinson's disease?
-Anticholinergic medications, like benztropine, are used to decrease the excessive cholinergic activity caused by the dopamine deficiency. They help reduce symptoms like tremors and rigidity but are typically prescribed to younger patients due to potential side effects.
Which group of patients is more likely to experience extreme tremors in Parkinson's disease?
-Younger patients with Parkinson's disease are more likely to experience extreme tremors and may be prescribed anticholinergic medications to help manage these symptoms.
What are some common early signs and symptoms of Parkinson's disease?
-Early signs and symptoms of Parkinson's disease can be subtle and may include tremors at rest, stiffness of extremities, and changes in walking posture. These symptoms often start in one extremity or side of the body and can progress to affect the entire body over time.
How can patients with Parkinson's disease manage 'freeze ups' during walking?
-Patients can manage 'freeze ups' by changing the direction of movement, using a cane or walker with a laser pointer to guide their steps, or consciously making an effort to raise their legs high as if marching or stepping over an object.
What are some nursing interventions for patients with Parkinson's disease?
-Nursing interventions include ensuring safety through the use of assistive devices and education on preventing falls, addressing psychosocial needs to reduce isolation and depression, and managing digestion and nutrition issues such as constipation and difficulties with swallowing.
Why is it important for patients with Parkinson's disease to be cautious with their diet, especially protein intake?
-It is important because protein can compete with Parkinson's medications, such as carbidopa-levodopa, in the small intestine, potentially reducing the absorption of the medication and affecting its effectiveness.
What are some side effects of carbidopa-levodopa, and how can they be managed?
-Side effects of carbidopa-levodopa include nausea and involuntary movements. To manage these, patients may be prescribed COMT inhibitors, such as entacapone, to extend the effect of levodopa and reduce the 'wearing off' phenomenon.
How do monoamine oxidase type B inhibitors help in the treatment of Parkinson's disease?
-Monoamine oxidase type B inhibitors, such as selegiline, increase dopamine levels by inhibiting the enzyme that breaks down dopamine, leading to an improvement in motor symptoms.
Outlines
π§ Parkinson's Disease Overview
This paragraph introduces Parkinson's disease as a neurological condition affecting movement, characterized by the degeneration of dopaminergic neurons in the substantia nigra. The significance of dopamine in movement accuracy is highlighted, and the imbalance between acetylcholine and dopamine is discussed. The paragraph also touches on the treatment approach, including anticholinergic medications, and the importance of dopamine in maintaining normal movement.
π΅ Signs and Symptoms of Parkinson's
The second paragraph delves into the signs and symptoms of Parkinson's disease, which initially may be subtle but worsen over time, affecting mobility. Tremors, stiffness, and bradykinesia (slow movement) are common, with tremors often improving with purposeful movement. The paragraph also covers other symptoms such as difficulty in swallowing, facial expression changes, and the progression of symptoms from one side of the body to the whole body.
πββοΈ Nursing Interventions for Parkinson's
This section focuses on nursing interventions for Parkinson's patients, emphasizing safety due to balance and coordination issues. It discusses the use of assistive devices, environmental modifications, and strategies to manage 'freeze ups' during walking. The importance of psychosocial support, addressing depression, and maintaining autonomy through adaptive clothing and utensils is also highlighted.
π½οΈ Digestion and Nutrition in Parkinson's
The fourth paragraph addresses the challenges Parkinson's patients face with digestion and nutrition, including constipation and difficulties with swallowing and chewing. Recommendations for a soft diet, high-fiber intake, and adequate fluid consumption are provided. The role of speech-language pathologists in assessing and managing these issues is mentioned, along with the importance of timing medication intake with meals to optimize absorption.
π Medications for Parkinson's Disease
This paragraph discusses various medications used to treat Parkinson's disease, including carbidopa with levodopa (Sinemet), dopamine agonists like ropinirole (Requip), antivirals like amantadine, anticholinergics like benztropine (Cogentin), and monoamine oxidase inhibitors like selegiline (Zelapar). The paragraph also covers the importance of diet considerations when taking these medications, such as avoiding high protein meals and foods high in tyramine.
π Conclusion and Further Resources
The final paragraph wraps up the discussion on Parkinson's disease, summarizing the key points and encouraging viewers to take a free quiz and subscribe for more educational content. It emphasizes the importance of understanding the disease and its management, highlighting the role of medication and lifestyle adjustments in improving the quality of life for patients.
Mindmap
Keywords
π‘Parkinson's Disease
π‘Dopaminergic Neurons
π‘Acetylcholine
π‘Bradykinesia
π‘Tremors
π‘Rigidity
π‘Anticholinergic Medications
π‘Levodopa
π‘Nursing Interventions
π‘Constipation
π‘Dopamine Agonists
Highlights
Parkinson's disease is a movement disorder affecting the dopaminergic neurons in the substantia nigra.
Dopaminergic neuron death leads to reduced dopamine production, impacting movement accuracy.
A balance between acetylcholine and dopamine is crucial, with Parkinson's causing an over-activity of acetylcholine.
Anticholinergic medications can be used to treat tremors in younger Parkinson's patients.
Parkinson's typically affects older adults but can also occur in younger individuals, like actor Michael J. Fox.
There is no cure for Parkinson's, but medications can alleviate symptoms.
Early signs of Parkinson's can be subtle and often start unilaterally before progressing.
Common symptoms include tremors at rest, which may appear as 'pill-rolling' in the hands.
Stiffness can cause a shuffling gait and difficulty with voluntary movements, known as 'freezing'.
Bradykinesia refers to the slowness of movement experienced by Parkinson's patients.
Coordination issues can result in problems with swallowing, facial expressions, and speech.
Non-motor symptoms such as loss of smell and constipation are also associated with Parkinson's.
Nursing interventions should focus on safety, psychosocial support, digestion, nutrition, and medication education.
Assistive devices and environmental modifications can improve patient safety and prevent falls.
Education on handling 'freeze ups' and the use of devices like laser-point canes can assist with mobility.
Support groups and maintaining autonomy in daily activities can help combat isolation and depression.
Dietary adjustments, like soft foods and high-fiber intake, are important for managing digestion and nutrition issues.
Medications like carbidopa/levodopa, dopamine agonists, and COMT inhibitors are used to manage symptoms.
Education on medication side effects and dietary restrictions, especially regarding protein intake, is crucial.
Transcripts
this is cereth registered nurse RN comm
and in this video i'm going to be going
over parkinson's disease in this video
is part of an in clicks review series
over the neuro system and as always at
the end of this youtube video you can
access the free quiz i will test you on
this condition so let's get started
first let's start out talking about what
is parkinson's disease it is a neuro
disease that affects movement so
whenever you're studying parkinson's
remember that it is a movement disorder
disease and a lot of your signs and
symptoms are going to deal with
movements now why is this happening why
is there movement being affected
well these dopaminergic neurons start to
die that are located in the substantia
Niagra now where is the substantia
located if you were to look at the side
of the brain here where the red square
is you would see where the substantia
would be located and this area is
part of the basal ganglia which is part
of the midbrain that controls our
movement so if you look deeper and you
took a section of the midbrain you could
find the substantia
and here where these arrows are pointing
you will see that it's black hence why
it's last part of its name is Niagara
which means black and here the
dopaminergic neurons are dying and what
do dopaminergic neurons release they
release the neurotransmitter dopamine so
if they are dying this leads to less
dopamine being produced now what is the
significance of this why is this an
issue
well because dopamine provides us with
accuracy with our movements so if we are
losing this not having a lot of it we're
gonna have problems
so over here we had a normal
dopaminergic neuron it's nice and
healthy
so it's releasing the neurotransmitter
dopamine and those receptors are gladly
accepting that and we're getting normal
movement however over here to contrast
it we have
a dopaminergic neuron that is dying it's
not very healthy so because of that it
can't release a lot of dopamine so those
receptors are fine they're there they're
wanting to take that dopamine which
makes it a little bit different than
these other neuro diseases that we've
talked about the receptors are fine it's
just the issue with the neurotransmitter
so we're getting abnormal movement now
let's talk about the relationship
between acetylcholine and dopamine in
the nervous system there's always this
balance between acetylcholine and Dubb
Amin now acetylcholine is an excitatory
neurotransmitter and it causes
cholinergic activity we talked a lot
about what cholinergic activity does and
our sympathetic versus parasympathetic
video so if you're not familiar with it
be sure to check out that video now
dopamine on the other hand has
inhibitory properties so it's an
inhibitory neurotransmitter so what's
happening in Parkinson's like we've just
talked about there's less dopamine the
neurotransmitter dopamine hanging out at
those receptor sites so that throws off
the balance between acetylcholine and
dopamine so because acetylcholine is an
excitatory neurotransmitter it's going
to cause over stimulation of those
neurons and so that's why you're gonna
see a lot of those signs and symptoms
like tremors rigidity etc which we're
gonna go in detail here in a second and
another thing I want to point out is one
of the treatments like medications for
Parkinson's is to administer
anticholinergic medications to slow down
this cholinergic activity that's going
on and typically it's prescribed for
patients who are younger who have
Parkinson's disease rather than the
older adults because of the side effects
of the anticholinergic and these younger
patients usually are experiencing
extreme tremors so we can give them
these medications and help with that now
let's talk about some key points of this
disease along with the signs and
symptoms it can cause okay Parkinson's
disease tends to usually affect the
older adult population like 60 plus
however it can of
young people for instance a well-known
actor his name is Michael J Fox was
diagnosed with Parkinson's disease at
the age of 29 so young people can get
this disease currently there is no cure
for Parkinson's however medications can
be prescribed which can decrease the
signs and symptoms and we're going to go
over them a little bit later and the
cause of Parkinson's is not fully
understood they think maybe it could be
genetic or an environmental issue now
let's talk about the signs in the
symptoms okay at first in the early
stages of Parkinson's disease the signs
of symptoms tend to be subtle so the
patient or people around them will not
notice the signs and symptoms however as
time goes on they the signs and symptoms
will become worse and the patient will
notice them because it'll affect their
mobility along with the people around
them will see them as well and the signs
and symptoms tend to vary every patient
will be different with what they
experience so remember that also with
Parkinson's a sign and symptom can start
out in one extremity or just one side of
the body and those early stages and then
as time goes on it will progress
throughout the whole body so what is a
common sign and symptom experienced in
Parkinson's disease it is tremors
tremors that will occur at rest and they
can occur in the hands the arms the legs
and even the lips and the tongue now
when the patient experiences tremors of
the fingers and the hand we call this
pill rolling and just as the name says
the hand in the fingers will tremor and
it looks just like the patient is
rolling a pill in between their fingers
so remember this term and Assefa nishan
and as I go throughout the lecture if
you see something that has a unique
nickname remember that because it's
probably gonna be on your exam and one
thing to remember about these tremors is
that they tend to improve with
purposeful movement
they're worse when they're resting
another thing they can experience is
stiffness of the extremities and this
can lead to the patient whenever they
walk instead of their arms swinging at
their side their arms will just be still
at their sides so they'll have an
abnormal looking gait also they can
experience what's called a kinesia and
this is where they lose the ability to
actually do movements voluntarily and
for instance they can be walking and all
of a sudden they frees up their legs
frees up and it feels like their feet
are just stuck to the ground and can't
move and this is term freeze ups in
Parkinson's disease and in our nursing
interventions we're gonna talk about
some education pieces you can provide to
the patient on how to deal with these
freeze ups because that is definitely a
safety issue for them also this
stiffness is going to lead to them
having a shuffling gait where they
really don't pick their feet up very
well as they walk and their posture is
going to be bent forward as they walk
and because of this stiffness they can
have what's called cogwheel rigidity one
of those fancy little nicknames I would
remember and this is where whenever you
passively move their arms for instance
toward their body that the arms will
just jerk back like this as you move
them and that's called cogwheel rigidity
another thing a patient can experience
is called brady kinesia and this is
where their movements are slow so just
look at the word if you were on exam and
you don't know what this word means just
try to dissect it brady means slow like
bradycardia no it's slow heart rate and
kinesia is dealing with movement so they
have slow movements and this can affect
a lot of things for instance they're
swallowing because whenever we are
swallowing we're doing a lot of movement
and we need dopamine to help us with
that so if we don't have a lot of
available they're gonna slow down be
sluggish so they can have difficulty
swallowing food and they can experience
drooling because all that slow Ava's
just staying in their mouth and it can
pull outward because another thing
they're gonna have
like this expressionless faith and it
can be masked like from again where
their movements in their face if they're
gonna smile make some type of
expressions really not going to happen
because those movements are so slow they
can have chewing issues and they can
have speech issues where their voice is
really soft or slurred another thing
they can have is problems with
coordination so they're from a nursing
standpoint they are definitely at risk
for safety issues like Falls and hurting
themselves and again we talked about
this little bit earlier to compensate
for that because they're afraid of
falling they'll stoop forward to
compensate for that to make them
themselves feel like they have better
control of standing now some Nollan
motor signs and symptoms they can
experience is like loss of smell they're
not for sure why that happens but many
times Parkinson's patients tend to say
I've lost my sense of smell they can
also have constipation and again that's
dealing with the GI tract the movement
of those intestines thats slowed down so
they can deal have issues with that and
depression so to help us understand what
a patient let's say with late stage
Parkinson's disease would look like
let's look at this illustration okay
right off the bat we can see as this
patient is standing it's illustrating
him with movement he is bent forward and
if you take a closer look at his face
his face is expressionless
he even has a little bit of drooping in
his face from where the movements are
very slow so it gives him that like
mask-like appearance his hand has a
tremor and then down at the bottom his
feet don't really raised off the ground
as he walks he has like a shuffled type
gait now let's switch gears and talk
about nursing interventions okay based
on all that material we just learned we
should be pulling from our nursing
knowledge and be thinking of some
certain areas that we want to be
intervening
in and these areas include safety
because these patients are gonna have
balance coordination problems because
again this is a movement and disorder so
we've got to watch them with that cuz we
don't want them to fall also they can
experience freeze ups where once the
freeze up is over they increase the risk
of injury so we want to be providing
education about that
another thing is psychosocial these
patients one of the signs and symptoms
is depression also they're going to be
losing the ability as a disease
progresses to take care of themselves so
they're gonna lose their autonomy and
this can make them feel very isolated so
we want to concentrate on that
another thing is digestion and nutrition
they're gonna have constipation issues
and due to the difficulty chewing and
swallowing there's some things we can
help them do with improving that so they
make sure that they're getting as many
calories as they need to maintain and
sustain life along with educating them
about medication side effects and the
education pieces that go with that
because as you're gonna see some of
these medications that they're
prescribed to treat their Parkinson's
has requirements of certain foods that
they need to limit or avoid so as I'm
going over that pay attention to those
points so first let's talk about safety
what can we do to keep our patients safe
well first we want to teach them how to
use assistive devices anywhere from
canes and walkers to handrails in the
bathroom
keeping rugs off the floor that can
cause them to slip along with making
sure if they have pets that those pets
don't get around their feet and cause
them to trip because these patients have
balance issues and to help them with
these balance issues you can tell them
that whenever they go to change
positions they need to do this slowly
and say that they lose their balance a
lot while they're walking they can use a
rubber tip cane that a single point to
help with maintaining stability also
shoe wear is very important they want to
wear a low heel shoe
without that Rubber Soul because those
rubber soles tend to grip to the floor
and this can lead to them tripping so
something other than that that's smooth
but not slick so now let's look at some
education pieces about those freeze ups
that patients can experience and again
this is where for instance say that the
patient's walking and in their walk all
of a sudden their legs freeze up they
can't move or what a patient's described
it is feeling like their feet are stuck
to the ground and they can't move and
after that freeze up there's an
increased risk of injury or fall so what
can you educate the patient to do to
help prevent that from happening okay
one thing is that while they're walking
walking at the freeze up occurs they can
try to change direction of movement so
say they were walking forward freeze up
happens they could try to change their
direction by maybe stepping to the side
another thing is is that they can use a
cane or a walker that has a laser point
to it so if they're using this device as
they use it a laser line will appear on
the ground and as they walk and if
freeze up occurs they will know where to
move their leg after that freeze up is
over so it gives them some coordination
about where they should move their foot
another thing is is as they walk they
need to consciously make the effort to
raise their legs as they walk like they
were marching or stepping over something
instead of having that shuffling type
gait and it's important that the patient
doesn't try to push through those freeze
ups instead just try to bear with it but
don't push through it and use either the
laser point cane which can help them
know where to step or just try to stand
still until the freeze up is over now
let's look at the psychosocial part okay
with these patients we want to help them
feel as autonomous as possible so it's
important that they are able to feed
themselves and do those basic activities
of daily living so it feels like they
have a sense of control over their life
and what
way we can do that is educate them and
show them where they can get special
cookware and utensils to help them be
able to still cook and feed themselves
because forks and spoons and knives
they're made in a different way for
patients who have Parkinson's disease
where they can still feed themselves
also dressing it's best if they put on
shirts that don't have buttons or
zippers which are hard to maneuver when
you're experiencing the tremors and
instead that they velcro so it's easily
to put on or it's just like a sweatshirt
that you slide over the head also the
patient wants to have shoes that they
don't have to tie they're like velcro
and to help prevent isolation there are
local support groups with other people
who are experiencing Parkinson's disease
where these people get together share
their stories and help encourage one
another with this disease so provide
your patient with that it's important to
exercise as much as possible and another
thing that you want to educate the
patients family members and people who
are going to help provide care to these
patients it's not to stress them out
with trying to rush them through their
activities or with getting ready or
presenting something stressful to them
because it actually makes their signs
and symptoms worse and we don't want to
do that and another thing if the
patient's going to have a busy day they
have a lot of things going on it's best
for them to do these activities when
their medications which we're gonna talk
about here in a moment are in their peak
now moving on to digestion and nutrition
because remember these patients are
probably going to experience
constipation and they're gonna have
issues swallowing and chewing so one
thing is that they can have a soft diet
of soft foods that don't require a lot
of chewing that's really easy to swallow
so on an exam if you see which options
are best for a patient with Parkinson's
disease always pick the food that's
easiest to chew and swallow don't pick
some big steak or a taco or something
like that and a lot of these patients
are going to be evaluated by
speech-language pathologists which will
look at their swallowing and chewing
abilities may recommend the liquids
become thickened with nectar honey thick
liquids and it's important that you
educate them about a high-fiber diet
with lots of fresh fruits and vegetables
and to drink at least 2 liters of fluid
per day unless contraindicated that
helps prevent constipation and per MD
order they can take a stool softener to
keep those stools soft and that's the
nurse you want to be asking when was
your last bowel movement if it was a
week ago that's not good and you want to
look at that abdomen listen about belly
sounds palpate on it make sure you don't
feel any hard masses and an education
piece which were really going to go over
here in a second when we talk about meds
is that they want to watch their protein
intake like they need protein so they
need to incorporate that in their diet
but they don't want to eat a protein
rich meal when they take their
medication because they're anti
Parkinson medication because some of
these medications compete with protein
in the small intestine which will
decrease the absorption of that
Parkinson Parkinson medication now let's
talk about medications used to treat
Parkinson's disease now remember these
drugs do not cure the disease but will
help decrease those motor signs and
symptoms so the first thing I want to
talk about is called carbidopa with
levodopa so it's a combination drug and
its brand name is called cinnamon and
what it does is it adds more dopamine in
the brain which is what we need because
we're low on it and how it works is it's
pretty interesting is that the carbidopa
of the pay after the patient ingests it
will prevent the levodopa from breaking
down in the blood so more of it can
cross over into the brain and whenever
the levodopa crosses over it will turn
into dopamine and help decrease those
signs and symptoms some side effects of
this medication include nausea and
involuntary movements now let's talk
about the education pieces associated
with carpet diaper levodopa and I really
want you to pay attention to these diet
pieces down here because it
and in clucks love to ask about that
okay so this medication if your patient
is newly prescribed it let them know
that it can take up to three weeks for
them to notice a decrease in their signs
and symptoms so it's not that the
medication is not working it just takes
a while to take effect also their body
fluids like Slava sweat can turn a dark
color so not to be alarmed by that it
happens with this drug and this drug if
a patient takes it for long-term use
they can start experiencing signs and
symptoms that are really pronounced
before their next scheduled dose of
their carpet Oh beloved open because the
drug is wore off and what they can
prescribe with this which we're going to
talk about here in a second is a comt
inhibitor like int a capone also called
common tan which will help decrease this
is wearing off from happening and this
medication should not be taken with a
mono amine inhibitor it can lead to
hypertensive crisis and the patient
doesn't need to take or consume high
amounts of foods or supplements
containing vitamin b6 it can decrease
the effectiveness of this medication
along with not taking their scheduled
dose of carpet OPA levodopa with a high
protein rich meal like milk and meats
and being things that are super high in
protein because protein and carpet OPA
levodopa compete in the small intestines
and the body will pick protein and it'll
decrease the absorption of this drug
another type of drug used to treat
Parkinson's disease it's called rope pin
or also known as Requip and it is a
dopamine agonist so it stimulates those
dopamine receptors which will help
improve those signs and symptoms it's
also used to treat conditions like
restless leg syndrome and one thing I
want to point out to you is that you
really want to educate your patient that
this can cause severe drowsiness where
they'll become so drowsy where they'll
abruptly fall asleep so they don't mean
to take this
medication before operating machinery or
driving or cooking or something like
that
because they may fall asleep another
type of drug used to treat Parkinson's
is called a manta gene and it is a it's
actually used as well as an antiviral in
the treatment of influenza A but this
drug they have found stimulates the
dopaminergic activity in the CNS which
helps with those signs and symptoms
another category of drug is used to
treat Parkinson's and we talked a little
bit about this in the beginning when we
were talking about the path of
Parkinson's it's called anticholinergics
and one kind is called Vince tripping
and its brand name is ko jintan and what
it does is it blocks the acetylcholine
so you get decreased and that call
energic activity because remember
there's an imbalance between
acetylcholine and dopamine and
acetylcholine was that excitatory
neurotransmitter and the dopamine was
inhibitory neurotransmitter so these
neurons are becoming overstimulated
and you can get those signs and symptoms
so this will help decrease rigidity also
decrease the salivation which will help
with that drooling and decrease signs
and symptoms however this is not for
patients who have glaucoma
so assess your patients history their
eye health and make sure that they don't
have glaucoma and some other things is
that they never want to just quit taking
this abruptly it can cause worsening of
signs and symptoms they will experience
dry mouth with this just because of what
it's doing on the cholinergic side so
sugarless gum or candy can help with
that and absolutely no alcohol while
taking this medication some other drugs
used to treat Parkinson's disease
include monoamine oxidase inhibitors
type B and a popular one is called
recycling also known as a select and
what this does is it increases dopamine
by stopping monoamine oxidase activity
so you're going to get improvement of
those signs and symptoms but there's
some important teaching parts with this
and I would definitely remember this
okay so
whenever any type of monoamine oxidase
inhibitor you don't want the patient
ingesting foods high in tyramine and
this would include foods like aged
cheese smoked cured meats fermented
foods and beer so they would definitely
want to limit those in their diet and
then last but not least are those comt
inhibitors that I talked about earlier
in the lecture when we are talking about
carpet OPA levodopa and popular one is
called intok apone also known as compton
and the comt stands for catechol o
methyl transferase inhibitor and this is
used what with what drug the carpet OPA
levodopa so the cinnamon now how does
this drug work because remember it's
used to decrease that wearing off phase
that can happen with carpet OPA levodopa
and when patients have been using it for
a long term because their signs and
symptoms they notice they're starting to
become more pronounced before that next
dose of their medication so what it'll
do it will block that comt enzyme that
will break down that levodopa in the
blood which will make it last longer
hence not have those signs and symptoms
okay so that wraps up this NCLEX review
over Parkinson's disease thank you so
much for watching don't forget to take
the free quiz and to subscribe to our
channel for more videos
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