Pathophysiology and Pharmacology7., ,Pathophysiology and Pharmacology
Parkinsons disease is a neurodegenerative disease that principally affects movement. Primary symptoms of Parkinsons disease include stiffness, slowing of movement (bradykinesia), impaired balance tremor and shuffling gait/ postural instability, while secondary symptoms include dementia, depression, and anxiety. According to Magrinell et al (2016), Parkinsons disease is a neurodegenerative condition with motor as well as nonmotor features.,Amongst motor signs and symptoms, the major clinical signs (rigidity, rest tremor and bradykinesia) are principally attributed to the death of dopamine neurons within the substantia nigra, while those involving gait, balance, and posture are basically as a result of relapse of nondopaminergic pathways and considerably lead to disability and impairment in patients with advanced Parkinsons disease.Pathophysiology and Pharmacology7.
Nonmotor features are caused by deficiencies in multiple neurotransmitters in the peripheral and central nervous system and entail psychiatric (delusions, hallucinations, apathy, and depression) and autonomic (genital and urinary disturbances, hypotension, constipation and orthostatic) features. Cognitive impairment involves executive functions, visuospatial and memory functions sleep disorders, pain, and olfactory dysfunction. Patient education related to Parkinsons disease (Marginelli et al, 2016).
Patients with Parkinsons disease need education on the symptoms of the disorder, the importance of exercise and safety issues. It is important to educate patients on the initial symptoms along with treatment options. Tarsy (2016) asserts that exercise can assist in preventing the complications of the disorder caused by rigidity along with flexed posture, like back, hip and shoulder pain. Aerobic exercises, like walking outdoors and swimming and riding on an immobile bicycle are normally energizing and simple to perform. Safety issues include fall prevention. Tarsy (2016) states that as Parkinson disease progresses, patients are at greater risk of tripping. To minimize this risk, caretakers and patients must be educated on how to ensure the home is secure through fixing shower grab-bars and adequately lighting the house, particularly at night.Pathophysiology and Pharmacology7.
Levodopa is the most effective and commonly used drug in the treatment of Parkinsons symptoms. As a dopamine replacement medication, levodopa acts by simulating presynaptic dopamine receptor so as to increase levels of dopamine in the brain. Dopamine must be administered through the mouth as levodopa because if it is administered exogenously, it cannot be able to go through the brain-blood barrier. According to Lilley et al (2019), levodopa is the biological antecedent of dopamine and can thus penetrate into the central nervous system. Dopa decarboxylase breaks down levodopa occurs outside the central nervous system, with very huge doses of oral levodopa being needed to attain sufficient levels.
The huge doses required contribute to huge levels of peripheral dopamine and cause numerous unwanted side effects These adverse effects include cardiac dysrhythmias, hypotension, confusion, muscle cramps, chorea, and gastrointestinal distress Thus, levodopa is administered with carbidopa which is an inhibitor of peripheral decarboxylase with no or little pharmacological action when administered alone. When administered together with levodopa, carbidopa prevents levodopa from being broken down within the periphery and therefore permit utilization of smaller levodopa doses (Lilley et al, 2019).Pathophysiology and Pharmacology7.
Carbidopa-levodopa must be utilized carefully and closely monitored in older patients, particularly those who had cardiac, endocrine, psychiatric, renal, pulmonary and hepatic disease in the past. Administration of carbidopa-levodopa in older adults predisposes hem to a greater risk of experiencing side-effects, particularly orthostatic hypotension, loss of appetite and confusion. Lilley et al (2019) assert that both carbidopa and levodopa are contraindicated in instances of angle-closure glaucoma. Nevertheless, they might be utilized with a lot of caution in people who have open-angle glaucoma. Both drugs should not be given individuals with undiagnosed skin diseases since they might stimulate malignant melanoma. A probable drug interaction might occur with vitamin B/pyridoxine. Pyridoxine diminishes the efficacy of carbidopa-levodopa but adjustment of dose can overcome the interaction,DQ 7.1
Choose a medical condition from the neurological, musculoskeletal, or integumentary system and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder? Choose a medical condition different from that of your fellow students.
Select a medication used in evidence-based treatment guidelines for the condition chosen in the first discussion question. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions of which one should be aware. Make sure that you select a different medication than your peers. Include the name of the medication in the subject line so that the medications can be followed. Include your references in APA style.Pathophysiology and Pharmacology7.