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    Parkinson's Disease

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    Parkinson's Disease

    Uploaded by

    27b7976xtj
    9 views15 pages

    Original Title

    4. Parkinson's Disease

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    9 views15 pages

    Parkinson's Disease

    Uploaded by

    27b7976xtj

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    © All Rights Reserved
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    of 15

    PARKINSONS

    Disease
    PARKINSON’S DISEASE
    PD is named after James Parkinson
    who in 1817 wrote a classic “shaking palsy” a
    disease for which the reason is still unknown.
    This is a progressive nervous system
    disorder that affects movement. Symptoms
    start gradually, sometimes with a barely
    noticeable tremor in just one hand. Tremors
    are common, but the disorder also causes
    stiffness or slowing of movement.
    Parkinson's disease (PD) is a
    chronic, progressive neurodegenerative
    disorder characterized by slowness in
    the initiation and execution of
    movement (bradykinesia), increased
    muscle tone (rigidity), tremors at rest,
    and gait changes.
    The famous
    internationally
    known boxer,
    MOHAMMED ALI
    suffered from
    this disease.
    § Family History: Having one or more
    § The exact cause is unknown
    close relatives with the disease
    § Heredity increases the risk of getting it.
    § Medications metoclopramide, § Advancing age: Above 60 years
    methyldopa, haloperidol, like mostly seen
    reserpine, lithium, and
    § Sex: males are more likely to get it
    chlorpromazine
    than females.
    § Agricultural work: exposure to
    § Low Estrogen Level: most
    environmental toxins such as
    menopausal women who don't use
    pesticides, and herbicides
    hormone replacement therapy are
    § Head injury. more at risk of getting the disease.

    ETIOLOGY
    Destruction the normal
    Antipsychotic drug, balance between
    Affects the
    encephalitis and Dopamine (DA) and
    substantia nigra acetylcholine (Ach) in
    other causes
    the basal ganglia

    Impaired extra
    Loss of motor Tremor, rigidity and
    pyramidal tract
    control Akinesia
    controlling

    PATHOPHYSIOLOGY
    CLINICAL MANIFESTATIONS
    Be – Bending/ forwarding tilt (Stooping Posture)
    S – Shuffling gait
    M – Mask-like face
    A – Akinesia/Bradykinesia
    R – Rigidity
    T – Tremor
    § Hypomimia
    § Drooling of saliva
    § Low-volume speech.
    § Dysarthria.
    § Problem with swallowing and
    Involuntary flow of saliva.
    § Longer time to complete a
    task.
    § Stiff face in advanced PD.
    § Altered cognitive function
    § Dementia.
    § Disorder of intellectual
    function.
    § CT scan or MRI of
    the head to rule out
    secondary cause.
    § PET scan to
    evaluate levodopa
    uptake and
    conversion to
    Dopamine in the
    Corpus Striatum.

    DIAGNOSIS
    1. Thalamotomy
    2. Pallidotomy
    3. Deep Brain Stimulation
    4. Neural Transplantation

    SURGICAL MANAGEMENT
    COLLABORATIVE MANAGEMENT
    ØThickened liquid diet to soft diet for dysphagia
    Ø Firm bed to prevent contractures
    ØAspiration precaution. Keep the client in an upright
    position when feeding
    ØIncrease fluid intake and fiber in the diet to prevent
    constipation
    PHARMACOTHERAPY
    Anticholinergics. Reduce rigidity and some of the
    tremors in Parkinson’s disease.
    - Artane (Trihexyphenidyl)
    - Cogentin (Benztropine)
    - Akineton (Biperiden)
    - Kemadrin (Procyclidine)
    - Parsidol (Ethopropazine)
    - Norflex (Orphenadrine)
    PHARMACOTHERAPY
    Dopaminergic - Improves muscle flexibility.
    - Levodopa, a precursor of dopamine can cross the blood-
    brain barrier.
    - Carbidopa with Levodopa (Sinemet) - Carbidopa
    reduces the destruction of levodopa at the periphery. A single
    dose per day is administered.
    PHARMACOTHERAPY
    Dopamine Agonists/ Antiviral Drugs. These
    medications act on the dopamine receptors and
    produce improvement in symptoms of Parkinsonism.
    - Symmetrel (Amantadine HCL)
    - Parlodel (Bromocriptine Mesylate)
    - Requip (Ropinirole HCL)
    - Antiviral/ Dopamine Agonists

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