October 31, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Dopamine agonists fall into two groups: derivatives of ergot (an alkaloid found in plants) and nonergot derivatives. The nonergot derivatives are highly selective to dopamine receptors. In contrast, the ergot derivatives are less selective.

October 30, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
In the absence of carbidopa, about 98% of levodopa is lost in the periphery, leaving only 2% available to the brain. This is due to decarboxylases in the GI tract. When this is inhibited by carbidopa, only 90% of levodopa is lost, leaving 10% available.

October 29, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Carbidopa is used to enhance the effects of levodopa, it has no therapeutic effect on its own. Carbidopa inhibits decarboxylation of levodopa in the intestine and peripheral tissues, thereby making more levodopa available to the CNS. 

October 28, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Treatment of levodopa-induced psychosis with first-generation antipsychotics is problematic. These agents can decrease psychologic symptoms. However, they will intensify symptoms of Parkinson's disease because they block dopamine receptors.

October 27, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Ironically, levodopa, which is given to alleviate movement disorders, actually causes movement disorders in many patients. Some dyskinesias are just annoying (head bobbing, tics), whereas others can be disabling (ballismus, choreoathetosis).

October 26, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Levodopa is administered orally and absorbed in the small intestine. Food delays absorption by slowing gastric emptying. Since neutral amino acids compete with levodopa for intestinal absorption, high-protein foods will reduce therapeutic effects.

October 25, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
When treating Parkinson's disease, levodopa is used instead of dopamine itself. There are two reasons. First, dopamine can't cross the blood-brain barrier. Second, dopamine has a short half-life in the blood and would be impractical.

October 24, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Levodopa has been a cornerstone of Parkinson's disease treatment. Unfortunately, although the drug is highly effective, beneficial effects diminish over time. The most troubling adverse effects are dyskinesias.

October 23, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
To manage Parkinson's disease, two types of drugs are used: (1) dopaminergic agents (drugs that directly or indirectly cause activation of dopamine receptors) and (2) anticholinergic agents (drugs that block receptors for ACh).

October 22, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
There is no drugs that can prevent neuronal damage or reverse damage that has already occurred in Parkinson's disease. Hence, the goal with current drugs is simply to improve the patient's ability to carry out activities of daily life.

October 21, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
In Parkinson's disease, there is an imbalance between dopamine and ACh. This imbalance results from degeneration of the neurons. In the absence of dopamine, the excitatory influence of ACh goes unopposed.

October 20, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Clonidine can intensify the subjective effects of some abused drugs, including benzodiazepines, cocaine and opioids. Since clonidine costs less than these drugs, the combination allows abusers to get high for less money.

October 19, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
People who abuse cocaine, opioids (morphine, heroin) and other drugs frequently abuse clonidine as well. At high doses, clonidine can cause subjective effects like euphoria, sedation and/or hallucinations.

October 18, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Clonidine can cause CNS depression. About 35% of patients experience drowsiness, some experience outright sedation. Patients in their early weeks of treatment should be advised to avoid hazardous activities if alertness is impaired.

October 17, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Clonidine is an alpha-adrenergic agonist that causes “selective” activation of alpha receptors in the CNS. By activating central alpha receptors, clonidine reduces sympathetic outflow to blood vessels and to the heart.

October 16, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Beta blockers fall into two groups: nonselective and cardioselective agents. The nonselective agents block beta and beta receptors, whereas the cardioselective agents block beta receptors only (at usual doses).

October 15, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
By “masking” tachycardia, propranolol can delay awareness of hypoglycemia. Diabetic patients who are taking propranolol should be warned that tachycardia may no longer be a reliable indicator of hypoglycemia. 

October 14, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Esmolol differs from the other beta blockers in that it is not used for hypertension. Because of its short half-life (15 minutes), esmolol is unsuited for treating hypertension, which requires maintenance of blood levels throughout the day.

October 13, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Use of beta blockers during pregnancy can have residual effects on the newborn infant. Beta blockers can remain in the circulation for several days after birth, neonates may be at risk for bradycardia, respiratory distress and hypoglycemia.

October 12, 2014

Nursing Tip of the Day! - Medical Surgical Nursing

Category: Medical Surgical Nursing 
Beta blockade inhibits the breakdown of glycogen into glucose, posing a risk of hypoglycemia. Although suppression of glycogenolysis is inconsequential for most people, interference with this process can be detrimental to patients with diabetes.