Term
whcih stage is this
-no clinical symptoms |
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Definition
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Term
whcih stage is this
one sided involvment |
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Definition
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Term
whcih stage is this
bilateral invovlement |
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Definition
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Term
whcih stage is this
mild postural abnormalties with hx of poor balance |
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Definition
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Term
whcih stage is this:
posstural instabilitiry and worseing bradykinesia /rigidity |
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Definition
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Term
whcih stage is this
cant walk or stand and cognitive/gi bad |
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Definition
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Term
| staging for Pd is based on |
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Definition
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Term
| adaptive strategies and increasing assistance arent needed until stage _ |
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Definition
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Term
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Definition
bradykinesia
psotural abdnormal
resting tremor
rigidity |
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Term
| what are the 2 funcitonal scales to asses Pd |
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Definition
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Term
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Definition
| basic acitvies like dressing and eating |
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Term
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Definition
| complex acitvies like cooking, chores |
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Term
| which are impaired earlier, ADLs or IADLs |
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Definition
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Term
| what is the assessment for gait and balance in PD |
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Definition
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Term
| which test is the movement disorder assessment |
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Definition
| AIMS (does involuntary movements like temor, tic, etc) |
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Term
| which test can be used to asses PD symtpoms caused by drugs? |
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Definition
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Term
| cognition, moood assessments can be done but dont see until later in disease |
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Definition
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Term
| What is the gold standard for assessment of overal PD |
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Definition
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Term
| what are the prevention meds?-3 |
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Definition
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Term
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Definition
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Term
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Definition
blocks MAO B MPTP-> MPP+
antioxdiants like glutathion/superpxide |
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Term
| is selegline effective prevention? |
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Definition
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Term
| which bran ddname of selegline is used for depression |
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Definition
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Term
| inital dosse of selegline |
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Definition
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Term
| all products of selegline is contraindicated with-3 |
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Definition
meperidine
methadone
other MAOIs |
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Term
| the patch and disintegrating tablet of selegline are contraindcated with-4 |
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Definition
| DM, CBZ, bupropion, St johns Wort |
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Term
| brand name of selegline patch |
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Definition
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Term
| brand name of selegline oral disentrgating |
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Definition
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Term
| brand name of selelgline reugular release |
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Definition
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Term
| the patch of selegline by itself is contraindicated for-5 |
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Definition
| tryamine food, SSRIs, ampetamines, local anesthesia, surgery with anestheis |
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Term
| primary risk for interaciton with selegline is |
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Definition
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Term
| dont start other selelgline rpoducts w/i _ wks of Zelpar |
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Definition
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Term
| 3 monitoring things for selegline |
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Definition
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Term
| which preventative can be monotherapy or adjunctive |
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Definition
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Term
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Definition
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Term
dose of rasagline monotheryp
adjunct with levodopa |
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Definition
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Term
| rasagline contraindicated with-4 |
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Definition
| tramadol, cocaine, and most of the ones for selegline |
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Term
| use rasagline in caution with-3 |
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Definition
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Term
| precautions of rasagline are-2 |
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Definition
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Term
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Definition
| hyoptension, bundle block, GI |
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Term
| rasagline caution eaating with |
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Definition
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Term
| monitoring for rasagline-3 |
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Definition
skin conditons
BP
PD symtpoms |
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Term
| alpha tocopherol (VIt E) effective? |
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Definition
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Term
| DATATOP trial showed that tho the preventive emds didnt delay start of levodopa, _ provided symtpom relief |
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Definition
| selegline (may delay start to levo, but not neuroprotective only bc less symtpoms) |
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Term
| selegline doesnt cause more mortality |
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Definition
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Term
| *rasagline has less clinical delcline at 6 onths, not sure if neurpprotiective or only symptom releief |
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Definition
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Term
| for dopamaine replacement, need to give- |
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Definition
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Term
| what is the minimum daily dose of carvidopa to be given? |
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Definition
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Term
| Carvidopa + levodopa = Sinumet |
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Definition
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Term
daily dose of levo -> CR
300-400=
500-600
700-800
900-1000 |
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Definition
50/200 1 BID
50/200 1 TID
50/200 4 tabs in 3 doses
50/200 5 tabs in 3 doses |
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Term
| what is the minimum interval btwn CR doses- |
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Definition
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Term
| Lodysn= 25 mg carvidopa to get daily dose of it |
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Definition
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Term
| levodopa contraindicated with-3 |
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Definition
| glaucoma, melenoma, undiagnosed skin conditions |
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Term
|
Definition
| hypotenion, arrythmia, hallucinations |
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Term
| whcih drug do you not abruptyly D/C |
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Definition
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Term
| drug interactions for Levodop-4 |
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Definition
| phenytoin, TCA, anatacids, MAOI |
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Term
| food interacitons for Levodpa |
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Definition
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Term
| what 2 tests can levo mess with |
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Definition
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Term
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Definition
PD symtpoms
BP
mental status
Sleep |
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Term
| por and con of immediate relase levodopa |
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Definition
pro- rapid onset
con- short duration |
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Term
|
Definition
pro- stradier delivery
con=delayed onset |
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Term
| *as pt uses levo fro longe,r freezing occurs and need mroe of med or adjunctives |
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Definition
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Term
| * there isno diff in tx complicaiotns for CR or immediate Levo |
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Definition
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Term
| when a person is on CR but needs jumpstart in morning what do you do? |
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Definition
| smaller dose of immediate levo |
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Term
other agent class besides slelgine to delay need for LEvo
when would you use these? |
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Definition
DA agonists
young pt who will need more yrs of therapy for PD |
|
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Term
| what are the 2 DA agonists |
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Definition
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Term
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Definition
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Term
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Definition
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Term
| starting dose of pramipexole |
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Definition
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Term
| starting does or ropinorole |
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Definition
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Term
titration for pramipexole
for ropnorole |
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Definition
increase each week by .5 TID
increase ea wk by .25 TID |
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Term
| *only contraidnicaiton for DA agonists is allergy |
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Definition
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Term
| monitoring for DA agonists-3 |
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Definition
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Term
| neither DA agonists of DA replacemnet is preferred inital therapy, can use either* |
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Definition
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Term
what agents can help with tremor, but not other ymtpoms
which pt population cant they be used in and why |
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Definition
anticholinergics
elderly bc of cognition issues |
|
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Term
| examples of anticholinergics-2 |
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Definition
benztropine
diphenhydramine |
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Term
| anticholinergics treat symptoms not the problems so be careful when uses |
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Definition
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Term
| what drug is jsut like the anticholinergics for use and caution in pts |
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Definition
| amantadine (for this drug its bc of renal function for elderly) |
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Term
| combo therapy is where if not on selegline or rasagline they are added- can help dealy wearing off of levodopa and allow reduciton of levo dse |
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Definition
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Term
| * can use DA agonist and DA replacement tofether |
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Definition
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Term
| what med is used in combo with Levo to reduced motor complications assoc with ELvo therapy? |
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Definition
| COMT inhibitors i.e Entacapone |
|
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Term
| why is entacapone the preffereed COMT inhibitore? |
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Definition
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Term
| Stalevo is combo of entacapone, levo, aand carbido *can increase risk of stroke |
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Definition
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Term
| starting dose of entacapaone |
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Definition
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Term
| only contraindicaiton for entacapone is allergy |
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Definition
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Term
what is the end stage rescue DA agonist
how is it admin |
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Definition
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Term
| contraindiaction for apormorphine |
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Definition
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Term
| if problem with peak dose: |
|
Definition
| switch immed to CR; or more freq intervals |
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Term
| if dysotnia related to peak effect |
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Definition
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Term
| dysknaisea with peak effect- |
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Definition
| parial DA agonsit (teguride) |
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Term
|
Definition
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Term
| if freezing occurs (pt becomes stiff) |
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Definition
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|
Term
| if rando fluctuations occur |
|
Definition
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Term
|
Definition
| decrase nighttime car/levo |
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Term
|
Definition
| use antianxiety like lorazepam |
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Term
Alzhimers symtpoms in early stage PD can mean-?
what med can be used? |
|
Definition
lewy body dementia/ parkisons dementia
rivastigmine |
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Term
| * remebers non med interventions needed for fall risk and GI probs |
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Definition
|
|
Term
| signs parkisons is in actulity lewy body dementia-3 |
|
Definition
cog impair early in disease
donest repsond to parkisons drugs
visural hallucinations |
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Term
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Definition
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