Anticholinergics drugs block parasympathetic nerves thereby enabling
impulses from sympathetic nerves to take control. Anticholinergic and adrener-
gic drugs produce many of the same responses.
A list of anticholinergic drugs are provided in the Appendix. Detailed tables
show doses, recommendations, expectations, side effects, contraindications, and
more; available on the book’s Web site (see URL in Appendix).Antiparkinsonism-Anticholinergic Drugs
Antiparkinsonism-anticholinergic drugs are used to treat the early stages of
Parkinson’s disease. These are typically combined with levodopa to control
parkinsonism or alone to treat pseudoparkinsonism. These are the parkinsonism-
like side effects of phenothiazines, which is an antipsychotic medication.Drugs for Parkinsonism
Parkinsonism, better known as Parkinson’s disease, is a chronic neurological
disorder that affects balance and locomotion at the extrapyramidal motor tract.
It is considered a syndrome because it has a combination of symptoms.
Parkinsonism has three major features. These are rigidity, bradykinesia (slow
movements), and tremors.
Rigidity is the abnormal increase in muscle tone that causes the patient to
make postural changes such a shuffling gate, the chest and head is thrust forward,
and knees and hips are flexed. The patient walks without swinging his arms.
These movements are slow (bradykinesia) and the patient exhibits involuntary
tremors of the head and neck which may be more prevalent at rest and pill-rolling
movements of the hands. Another characteristic symptoms is the masked facies
(no facial expression) common in patients with Parkinson’s disease.
There are four types of drugs used to treat Parkinson’s disease:dopaminer-
gics, dopamine agonists, MAO-B inhibitors, and anticholinergics which have
been discussed previously in this chapter.
Dopaminergics decrease the symptoms of Parkinson’s disease by permitting
more levodopa to reach the nerve terminal where levodopa is transformed into
dopamine and the tremors are reduced.
Dopamine agonists stimulate the dopamine receptors and reduce the symp-
toms of Parkinson’s disease. MAO-B inhibitors inhibit the catabolic enzymes
that break down dopamine thereby extending the effects of dopamine. However
they can cause a hypertensive crisis if taken with certain foods (see Table 15-1).(^288) CHAPTER 15 Nervous System Drugs