Parkinson's disease is characterized by deficiency of neurotransmitter?

HPSSC Staff Nurse - 2021

Medical & Surgical Nursing

Easy

Appeared in: HPSSC Staff Nurse - 2021

Explanation

Parkinson's disease is fundamentally a disorder of the basal ganglia caused by the progressive loss of dopamine-producing neurons in the substantia nigra.
This loss leads to a marked reduction in the brain's dopamine concentration, which is a neurotransmitter critical for coordinating and controlling body movement.
The resulting dopamine deficiency disrupts the normal balance of brain signaling, leading directly to the cardinal motor symptoms of the disease: tremor, rigidity, and bradykinesia.
Pharmacological treatment for Parkinson's disease aims to restore this dopaminergic activity, for example, by using Levodopa, a precursor to dopamine.

Option A: In Parkinson's disease, acetylcholine is not deficient. Due to the lack of inhibitory dopamine, acetylcholine's excitatory effects become unopposed, leading to a state of relative overactivity which contributes to the motor symptoms.
Option C: While serotonin levels can be reduced in Parkinson's patients, this is primarily associated with non-motor symptoms like depression, anxiety, and sleep disturbances, not the defining motor deficits of the disease.
Option D: GABA (gamma-aminobutyric acid) is the main inhibitory neurotransmitter in the central nervous system. Its pathways are affected by the loss of dopamine, but a primary deficiency of GABA itself is not the cause of Parkinson's disease.

Clinical Relevance

Nursing practice connection: Knowing Neurotransmitter deficiency in Parkinson's disease helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Understanding that Parkinson's is a dopamine-deficiency state is crucial for nursing care, especially regarding medication management. Levodopa/carbidopa must be given on a strict schedule to prevent sudden worsening of symptoms ('off' periods).
Nurses must educate patients and families about the 'on-off' phenomenon and the importance of medication adherence for maintaining functional ability and quality of life.
What if? If a patient with Parkinson's disease suddenly develops severe confusion and hallucinations, the nurse should consider that these may be side effects of dopamine-agonist medications, rather than a primary psychiatric issue, and notify the provider. The treatment might involve reducing the dose of the antiparkinsonian drug, not adding an antipsychotic which could worsen motor symptoms.

How to Approach the Question

First, identify the core subject of the question, which is 'Parkinson's disease'.
Next, pinpoint the specific concept being asked: the 'deficiency' of a 'neurotransmitter'.
This is a factual recall question. Access your knowledge of the pathophysiology of major neurological disorders.
Recall that Parkinson's disease is the classic example of a movement disorder caused by the loss of dopamine-producing cells.
Evaluate the options: Acetylcholine is relatively excessive, Serotonin relates to mood, and GABA deficiency is linked to Huntington's. This confirms Dopamine is the correct answer.

Concept Tested & Keywords

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E6 Pharmacology Katzung 16e p. 771-773