NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Parkinson's Disease (PD) in Acute Care

What is the “Get it on time” campaign and why is it important?

  • Access to the correct medications at the right time can be a problem for patients with PD when they are admitted to hospital
  • This led Parkinson’s UK to initiate the “Get it on time” campaign to ensure PD medications are received on time every time 
  • NICE recommends that levodopa should be taken within 30 minutes of its prescribed time
  • It is crucial not to stop, omit or delay PD medications for any significant length of time (> 2hours) as this may cause significant exacerbation of symptoms and patient distress
  • In some cases, particularly in patients with advanced PD or who are on high doses of PD medications, missing PD medicines increases the risk of developing neuroleptic malignant like syndrome (Parkinsonism hyperpyrexia syndrome) which may be fatal

What role can I play in supporting patients with PD?

  • Consider referring patients with PD to PD nurse specialists on admission to hospital - see contact details within GGC Adult Therapeutics Handbook (Appendix 6)
  • General advice on the management of patients with PD in acute is available within the Adult Therapeutics Handbook-Parkinson's disease in Acute Care 
  • Ensure medicines reconciliation is undertaken within 24 hours of admission – include the following: drug name, formulation, strength, dose and frequency. Please note: exact dose timing of PD medications should be clearly annotated on the prescription chart (Kardex) as exemplified below:

  • Ensure PD medications are given on time.  If PD medications are unavailable on the ward, contact holding areas (list available on StaffNet) or pharmacy for a supply immediately (even if out of hours)
  • If PD specialists are not available (e.g. out of hours) and PD specific advice is required in patients who are nil by mouth, on Duodopa® Intestinal Gel pump or apomorphine subcutaneous infusion, refer to GGC resources described below and follow the guidance given until PD specialist advice becomes available
  • The Duodopa® helpline and apomorphine (APO-go®) helpline can be contacted by healthcare professionals if advice is required and a PD specialist is not available for patients who are already established on therapy

What GGC resources are available to help with the management of patients with PD?

 1.   Adult Therapeutics Handbook-Parkinson's disease in Acute Care 

 2.   StaffNet-Parkinson's disease Nil by Mouth Guidance

 3.   StaffNet-Parkinson's disease medication stocklist, acute hospitals

 4.   StaffNet- Apomorphine Subcutaneous Infusion Treatment in patients admitted to hospital

 5.   StaffNet- Duodopa® Monograph for maintaining co-careldopa (Duodopa®) in patients admitted to hospital

 6.   Medicines Update Extra – Parkinson’s Disease in Acute Care

 

A series of clinical scenarios relating to PD patients on admission to hospital will follow.

 

Published 14/09/2020. Medicines Update blogs are correct at the time of publication.