Parkinson's Disease

Parkinson's Disease

Risk factors
Nursing Care plan
Pathophysiology
1. Disease of basal ganglia
  1. Characterised by:
    1. Slowness in the initiation and execution of movement,
    2. Increased muscle tone
    3. Tremor at rest
    4. Impaired postural reflexes
2. Neurons that supply dopamine to the striatum degenerates.
  1. When there is defects of dopamine, the excitatory effects of acetylcholine go unopposed resulting in disturbed movements.
Signs and symptoms
1. Tremor
  1. Hand
    1. Pill rolling
  2. diaphragm, tongue, lips and jaw
  3. Can rarely cause shaking of the head
2. Rigidity
  1. Increased resistance to passive motion when limbs go through their range of motion
  2. Caused by sustained muscle contractions
  3. Can cause pain and slowness in movement
3. Bradykinesia/Akinesia (Immobility)
  1. Loss of automatic movements
    1. Blinking of the eyelids
    2. Swinging of the arms while walking
    3. Swallowing of saliva
    4. Self-expression with facial and hand movements
  2. Primary evidence is the physical and chemical alteration of the basal ganglia and related structures in the extrapyramidal portion of the CNS
4. Posturing
  1. Shuffling gait with short steps
    1. Parkinsonian Gait
    2. Festination
  2. Postral instability is common
  3. Forward tilt of the trunk
  4. Propulsion and Retropulsion
    1. Forward bending and backwards bending
Medications
1. Anticholinergic
2. Dopaminergic
  1. Levodopa with carbidopa
    1. Also called sinemet
    2. Precursor of DA and crosses blood-brain barrier
    3. Converted to DA in the basal ganglia
    4. Carbidopa inhibits an enzyme that breaks down levodopa before it reaches the brain.
3. Antihistamine
4. monoamine oxidase inhibitor
5. Catechol-O-methyl transferase (COMT) inhibitor
Complications

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	Creado por Nicole Russell hace más de 7 años