Increasing the levels of dopamine in the substantia nigra Directly stimulating

Increasing the levels of dopamine in the substantia

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Increasing the levels of dopamine in the substantia nigra Directly stimulating the dopamine receptors in that area Helping to restore the balance between the inhibitory and stimulating neurons Indications Relief of the signs and symptoms of idiopathic Parkinson’ s disease Pharmacokinetics Precursor of dopamine, crosses blood brain barrier, convers to dopamine Well absorbed from the GI tract and widely distributed in the body Metabolized in the liver and peripheral cells Excreted in the urine Crosses the placenta
Copyright © 2017 Wolters Kluwer • All Rights Reserved Dopaminergic (cont.) Dopaminergic (cont.) Contraindications Known allergy Angle closure glaucoma GI obstruction, pregnancy and lactation Cautions CV disease dysrhythmias, HTN Bronchial asthma H/O peptic ulcer Urinary tract obstruction Psychiatric disorders Renal & Kidney disease
Copyright © 2017 Wolters Kluwer • All Rights Reserved Dopaminergic (cont.) Dopaminergic (cont.) Adverse Reactions Anxiety Nervousness Headache Blurred vision Arrhythmias Bone Marrow suppression Hepatic dysfunction Drug-to-Drug Interactions MAOI’ s -> HTN crisis Vitamin B6 & Phenytoin -> decrease effect
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Copyright © 2017 Wolters Kluwer • All Rights Reserved Prototype Dopaminergic Prototype Dopaminergic
Copyright © 2017 Wolters Kluwer • All Rights Reserved Other Dopaminergics Used in the Treatment of Parkinsonism Other Dopaminergics Used in the Treatment of Parkinsonism Amantadine ( Symmetrel ) Apomorphine (Apokyn)-parental & PO Bromocriptine ( Parlodel )-parental & PO Pergolide ( Permax ) Pramipexole ( Mirapex ) Rasagiline (Azilect) Ropinirole ( Requip ) Rotigotine (Neupro)-only transdermal
Copyright © 2017 Wolters Kluwer • All Rights Reserved Nursing Considerations for Dopaminergic Nursing Considerations for Dopaminergic Assess before administration: History- Dysrhythmias, Hyper/hypotension, GI depression or obstruction, urinary hesitancy or obstruction, benign prostatic hypertrophy, or glaucoma, pregnancy/breastfeeding Physical- VS, orientation, affect, reflexes, grip strength, gait, tremors, spasticity, vision, bowel sounds, urine output, lesions Known allergies Renal and liver function tests
Copyright © 2017 Wolters Kluwer • All Rights Reserved Nursing Considerations Cont.

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