Antiparkinsonian Medication: Nursing & Patient Care
Nursing Diagnoses in Patients on Antiparkinsonian Drugs
- Risk of falls: Related to dyskinesia, loss of balance, and orthostatic hypotension.
- Knowledge deficit: Regarding medication management.
- Constipation: A common side effect of some antiparkinsonian medications.
Dietary Recommendations for Antiparkinsonian Treatment
Rationale: Optimizing medication absorption and minimizing interactions.
- Take medication on an empty stomach. Food can be taken 15-20 minutes later to reduce gastric distress.
- Avoid taking levodopa with high-protein meals, as protein can interfere with levodopa absorption.
- Assess for multivitamin use or consumption of fortified cereals/milk with vitamin B6. These products should be avoided as B6 can reduce levodopa’s effectiveness.
Patient Education: Antiparkinsonian Treatment Side Effects
- Consult healthcare professionals if you have any doubts or if side effects significantly impact your quality of life.
- Do *not* abruptly stop treatment, as this could precipitate a severe parkinsonian crisis.
Understanding CNS Depression
Central Nervous System (CNS) depression exists on a spectrum, ranging from relaxation and sedation to sleep induction, anesthesia, and, in extreme cases, coma and death.
Anxiolytics and Hypnotics: Mechanism and Effects
Anxiolytic and hypnotic drugs primarily act on GABA-A receptors. These receptors are linked to chloride (Cl-) channels. Stimulation of these channels leads to an influx of chloride ions into the post-synaptic neuron, causing hyperpolarization and inhibiting CNS activity. Generally, these drugs have a calming effect at lower doses and induce sleep at higher doses.
Recognizing Benzodiazepine Overdose
A primary symptom of benzodiazepine overdose is difficulty awakening a person without any other apparent cause.
Benzodiazepine Side Effects in Elderly Patients
Excessive sedation in elderly patients can lead to immobility. Immobility increases the risk of secretion retention, predisposing the individual to pneumonia. Additionally, there’s an increased risk of disorientation and agitation.
Common Benzodiazepine Side Effects
Common side effects include drowsiness, ataxia (impaired coordination of voluntary movements), and psychomotor dysfunction.
Substances to Avoid with Benzodiazepines
- Stimulants: Caffeine, theine, and nicotine should be avoided as they counteract the effects of benzodiazepines.
- Other drugs: Avoid mixing with other drugs because it is incompatible with most of them and there is precipitation, both in the vessel and the catheter lumen. The solution is stable for a long. The ampoule should be diluted in saline or dextrose 5% and immediately administered for at least 30 minutes. Infuse over at least 20 minutes: if infused rapidly can cause severe drowsiness and to a lesser extent, respiratory depression.
Safety Measures for Patients on Benzodiazepines
- Avoid driving or engaging in hazardous activities until the drug’s effects are fully understood.
- Provide assistance with transfers, especially for elderly patients, until their balance and mobility are assessed.
- Having a chair beside the bed can be helpful when the patient is getting up.