McKenna's Pharmacology for Nursing, 2e

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P A R T 4  Drugs acting on the central and peripheral nervous systems

C H E C K Y O U R U N D E R S T A N D I N G

Answers to the questions in this chapter can be found in Appendix A at the back of this book.

6. Replacing dopamine in the brain would seem to be the best treatment for Parkinson’s disease. This is difficult because dopamine:

a. is broken down in gastric acid. b. is not available in drug form. c. cannot cross the blood–brain barrier.

MULTIPLE CHOICE Select the best answer to the following. 1. Parkinson’s disease is a progressive, chronic neurological disorder that is usually: a. associated with severe head injury. b. associated with chronic diseases. c. associated with old age. d. known to affect people of all ages with no known cause. 2. Parkinson’s disease reflects an imbalance between inhibitory and stimulating activity of nerves in the: a. reticular activating system. b. cerebellum.

d. is used peripherally before reaching the brain. 7. A person taking levodopa and over-the-counter

megavitamins might experience: a. cure from Parkinson’s disease. b. return of Parkinson’s symptoms. c. improved health and wellbeing. d. a resistance to viral infections.

8. A person who has been diagnosed with Parkin­ son’s disease for many years and whose symptoms were controlled using Sinemet has started to exhibit increasing signs of the disease. Possible treatment might include: a. increased exercise program. b. addition of benztropine to the drug regimen. c. combination therapy with an anticholinergic drug. d. changes in diet to eliminate vitamin B 6 . 1. A person asks the nurse to explain parkinsonism to him. Which of the following possible causes of parkinsonism might be included in the explanation? a. adverse effect of drug therapy b. brain injury c. viral infection d. dementia e. bacterial infection f. birth defect 2. No therapy is available that will stop the loss of neurons and the eventual decline of function in people with Parkinson’s disease. As a result, care should involve which of the following interventions? a. regular exercises to slow loss of function b. supportive education as drugs fail and new therapy is needed c. community and family support networking d. discontinuation of drug therapy to test for a cure e. special vitamin therapy to slow the loss of the neurons f. explanations of the adjunctive drug therapy that may be used MULTIPLE RESPONSE Select all that apply.

c. basal ganglia. d. limbic system. 3. The main underlying problem with Parkin­ son’s disease seems to be a decrease in the

neurotransmitter: a. acetylcholine. b. noradrenaline.

c. dopamine. d. serotonin. 4. Anticholinergic drugs are effective in early Parkin­ son’s disease. They act: a. to block stimulating effects of acetylcholine in the brain to bring activity back into balance. b. to block the signs and symptoms of the disease, making it more acceptable. c. to inhibit dopamine effects in the brain and increase neuron activity d. to increase the effectiveness of the inhibitory neurotransmitter GABA. 5. A person receiving an anticholinergic drug for Parkinson’s disease is planning a winter trip to Tahiti. The temperature in Tahiti is 20°C warmer than at home. What precautions should the person be urged to take? a. Take the drug with plenty of water to stay hydrated. b. Reduce dose and take precautions to reduce the risk for heat stroke. c. Wear sunglasses and use sunscreen because of photophobia that will develop. d. Avoid drinking the water to prevent gastric distress.