Medical-surgical Nursing Demystified

(Sean Pound) #1

CHAPTER 5 Nervous System^245



  • Orthostatic hypotension due to lack of norepinephrine within the sympa-
    thetic nervous system, affecting the cardiovascular system


INTERPRETING TEST RESULTS



  • Cerebrospinal fluid levels may show low levels of dopamine.


TREATMENT



  • Administer antiparkinsonian agents which are able to cross the blood-brain
    barrier. These drugs absorb better on an empty stomach:

    • levodopa

    • carbidopa-levodopa



  • Administer dopamine receptor agonists to act directly on the dopamine
    receptor sites:

    • pergolide

    • bromocriptine

    • pramipexole

    • ropinirole



  • Administer selegiline, a selective monoamine oxidase B inhibitor that slows
    the breakdown of dopamine and allows lower doses of levodopa to be used
    because it prolongs its effect.

  • Administer catechol O-methyltransferase (COMT) inhibitors which help block
    the breakdown of levodopa:

    • entacapone

    • tolcapone



  • Administer acetylcholine blocking drugs to decrease tremor and rigidity in
    patients:

    • biperiden

    • benztropine mesylate

    • procyclidine

    • orphenadrine

    • trihexyphenidyl



  • Diet high in protein and calories.

  • Soft food diet.

  • Physical therapy.

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