Medication Timing Critical In Parkinsons Disease
A one-week disruption of his Parkinsons medication schedule resulted in nearly three months of distress for Lorne Collis after he returned home from a brief hospital stay for a kidney ailment in December 2009. My tremors were uncontrollable, says Collis. My restless legs syndrome was extremely uncomfortable. It took about three months of getting back on my medication routine and exercising before my body felt normal again.
Its a common experience. People with Parkinsons enter hospital for reasons that may or may not be related to Parkinsons and find that the hospitals drug rounds do not coincide with their own medication regimen. However, in Parkinsons, a minor change in medication timing can have major negative effects on symptom management and general recovery.
The uneven release of dopamine can result in a person suddenly not being able to move, get out of bed or walk down a corridor. It can also lead to serious complications such as aspiration pneumonia and bowel obstruction.
When Parkinsons symptoms get out of control, it tends to exacerbate the reason why the person is in hospital. says Barbara Snelgrove, director of education and support services for Parkinson Society Canada. It also makes care of the person more difficult for healthcare professionals.
Get it on time is also being piloted in communities in Saskatchewan. In French, it is called Le prendre à temps. Parkinson Society Canada is seeking funding to roll out the program nationally.
Why Is Protein Important For People With Parkinsons
People with Parkinsons and seniors are at an increased risk for protein malnutrition. Not eating enough foods that contain protein is associated with slower wound healing, increased potential for falls, and greater risk of getting sick. Because seniors absorb protein differently, it is best to spread out protein intake consistently throughout the day.
When Medication Becomes Less Effective
If you have been taking medication for some time you may notice that its effects wear off before the next dose is due and so symptoms begin to return. This is known as wearing off and can affect both movement and non-motor symptoms such as anxiety or feeling low.
See Motor fluctuations for further information.
See Dyskinesia for further information.
Read Also: Nutrition For Parkinson’s Disease
What Are The Three Main Ways To Manage Parkinsons
The management of Parkinsons can be divided into three main areas:
- access to a multidisciplinary team this includes physiotherapists, occupational therapists, Parkinsons specialist nurses, and speech and language therapists, among others
In this section we will look at each of these areas in detail.
Why Is It Important To Take Medications Regularly
Medications should be taken regularly to make sure that you have an effective amount of drug in your body at all times. When medications are not taken regularly, the level of drug in the blood can become too low to effectively stop the virus from multiplying. This gives the virus a chance to mutate and become resistant to the effects of the drug.
Taking medications regularly means:
Taking your medications at the proper intervals during the day. Try to divide up your dosing times as evenly as possible throughout the day: for example, every 12 hours for a drug that needs to be taken twice a day, or every 8 hours for a drug that needs to be taken three times a day. Make up a schedule that fits into your daily routine, and try to take your medications within 1 hour of each scheduled time.
Taking all of your doses each day. It is virtually impossible for anyone to remember to take each and every medication dose properly. Missing an occasional dose is probably less of a concern than frequently missing doses or taking incorrect doses. If you forget a dose, take it as soon as you remember. However, if it is close to the time of your next dose, skip the dose and resume your schedule. Do not double your next dose because this could cause side effects.
Also Check: Parkinson’s Disease Specialist In Florida
Are There Clinical Trials For Parkinsons
A clinical trial is a research program done with patients to evaluate a new medical treatment, drug, or device. The goal is to find new and improved ways to treat diseases and conditions.
During a clinical trial, doctors use the best available treatment as a standard to evaluate new treatments. The new treatments are hoped to be at least as effective as — or possibly more effective than — the standard.
New treatment options are first carefully researched in the laboratory — in the test tube and in animals. Treatments most likely to work are further evaluated in a small group of humans. Then, they may be moved to a larger clinical trial.
When a new medical treatment is studied for the first time in humans, scientists don’t know exactly how itâll work. Any new treatment has possible risks and benefits. Clinical trials help doctors find out:
- If the treatment is safe and effective
- If the treatment could be better than treatments currently available
- The side effects of the treatment
- Possible risks of the treatment
Some advantages of taking part in a clinical trial are:
Some disadvantages of participating in a clinical trial are:
If you take part in a clinical trial, you may notice some changes in your care:
If you think you might want to take part in a clinical trial, find out as much as possible about the study before you decide. You can ask:
For information about ongoing Parkinson’s disease studies, contact the National Institutes of Health.
Interaction With Other Medicines
Many people with Parkinsons take other medicines to treat unrelated conditions. Because some medicines can interact with others, you should always tell your doctor or health professional about any other medicines, remedies or supplements you are taking. This includes over-the-counter medicines that have been bought without a prescription. Even some medicines used to relieve the symptoms of the common cold can affect some Parkinsons medicines, so it is important to ask your pharmacist which is the best one to take.
Some medicines may have harmful interactions with others known as contraindications. This can either make existing symptoms worse or bring on new Parkinsons-type symptoms that will disappear if you stop taking that medicine. If you have any worries or concerns about medication, discuss it with your doctor, Parkinsons nurse or pharmacist.
Also Check: Va C& p Exam For Parkinson’s Disease
Taking Care Of Business
The Parkinson’s Foundation has developed a thorough guide to getting your household and personal documents organized at www.parkinson.org
- Organize your medical histories
- Keep a journal of medications and dosages
- Organize your personal financial documents
- Insurance and long-term care plans
- Livings wills, durable power of attorney, advanced medical directives
The Importance Of Medication Timing
Why is it important that people with Parkinsons get their medication on time, every time? If people with Parkinsons are unable to take their Parkinsons medication at the right time, the balance of chemicals in their body can be severely disrupted. This leads to their Parkinsons becoming uncontrolled increasing their care needs considerably. This will mean that staff will need to do more for the person with Parkinsons than would otherwise have been necessary. It can take someone with Parkinsons a long time to get back to normal after this. Understandably, people with Parkinsons may be very anxious about getting their drugs on time. These times will differ from person to person and may not fit in easily with drug rounds.
Parkinsons UK run a campaign called Get It On Time to highlight the importance of people with Parkinsons getting their medication on time, every time. Further information is available on the Parkinsons UK Get It On Time webpage.
Read Also: Fitflop Shoes For Parkinson’s
What Foods Are Good Sources Of Protein
Good sources of protein include both animal and plant sources. Plant sources include beans, lentils, peas, nuts, seeds, and protein alternatives. Animal sources include meat, fish, poultry, eggs, milk, and cheese.
|Amount of protein in common foods|
|½ cup||0 grams|
Click here to find the amount of protein in different foods. Measure or weigh your portion size to obtain accurate results.
How Should I Take Carbidopa And Levodopa
If you already take levodopa, you must stop taking it at least 12 hours before you start taking carbidopa and levodopa.
Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.
Take carbidopa and levodopa at regular intervals, with or without food.
Swallow the capsule whole and do not crush, chew, break, or open it.
The tablet is sometimes broken in half to give the correct dose. Always swallow a whole or half tablet without chewing or crushing.
Place the orally disintegrating tablet in your mouth and allow it to dissolve, without chewing.
It may take up to several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve. Tell your doctor if the effects of this medicine wear off quickly between doses.
If you use this medicine long-term, you may need frequent medical tests.
This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using carbidopa and levodopa.
Do not stop using carbidopa and levodopa suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.
Store at room temperature away from moisture, heat, and light.
Read Also: Parkinson’s And Eye Twitching
Build A Unique Schedule
Establish a method and process to create and communicate the patients individualized medication schedule in order to control symptoms throughout the day. This requires clear communication between the patient-care unit and the pharmacy so patient-specific schedules are not overridden with standard dosing schedules.
Side Effects Of Medication
All prescribed medication can have potential side effects, including those used to treat Parkinsons.
Many people find their Parkinsons medication works very well when they start taking it, but this may change over time and side effects can develop.
Some things you think are symptoms of Parkinsons may actually be side effects of medication.
Some peoples side effects will have a big impact on their lives and have to be kept under control along with the symptoms.
Don’t Miss: Parkinson’s And The Mind
I Am Going Into Hospital For A Planned Admission And I Want To Make Sure I Get My Medication On Time How Can I Do This
Many hospitals will allow you to take your medication yourself during your stay. You can check this before you are admitted. Some hospitals dont allow patients to take their own medication and it has to be given to you by the ward nurse. If this is the case in the hospital you are going to make sure they know that you need your medication at times which are specific to you and your condition. Your Parkinsons nurse could help you arrange this.
When you go into hospital for a planned operation, you will often have a meeting to discuss your needs, known as a pre-operation assessment. This is a good time to tell medical staff that you need your medication at specific times and that you cant miss a dose.
How To Cope With Side Effects
What to do about:
- loss of appetite, feeling or being sick having a low-protein snack with your medicine may help if you’re feeling or being sick. If you lose your appetite, eat when you would usually expect to be hungry. It may help to eat smaller meals, more often than usual. If you are being sick, take small sips of water to avoid dehydration.
- feeling dizzy if you feel dizzy when you stand up, try getting up very slowly or stay sitting down until you feel better. If you begin to feel dizzy, lie down so you do not faint, then sit until you feel better. Do not drive, cycle, or use tools or machines if you feel dizzy or tired. Do not drink alcohol as it may make you feel worse.
- problems sleeping avoid big meals, smoking, or drinking alcohol, tea or coffee in the evening. Try not to watch TV or use your mobile phone before going to bed, and relax for an hour before bedtime. Do not take any sleep remedies, including herbal medicines, without talking to a pharmacist or your specialist nurse first.
- uncontrollable twitching, twisting orwrithingmovements let your doctor or specialist nurse know as soon as possible
Read Also: Names Of Parkinson’s Medication
Some Disadvantages Of Comt Inhibitors
If these side effects increase after starting the drug, people should raise the issue with their healthcare professional, as reducing the levodopa dose can often help.
COMT inhibtors will discolour urine making it a reddish-brown colour. Some people also experience diarrhoea which may occur some months after commencing the medication.
Be aware that other drugs for Parkinsons or other conditions can affect the action of COMT inhibitors. The combination of apomorphine and entacapone needs careful supervision.
Importance Of Taking Medications On Time
Chronic diseases cause an immense burden on the patient, with the requirement of taking pills daily. Taking medications on time is central to the success of therapy, and family or social support can play a vital role in decreasing the stress related to treatment thus improving compliance and outcomes.
It is by no way a new problem physicians had known the issue of compliance, that is a failure to stick to the treatment, providing wrong information to physicians and consequently having poor health outcomes for at least 2000 years.
Keep a watchon the faults of the patients, which often make them lie about the taking of things prescribed. For though not taking disagreeable drinks, purgative or other, they sometimes die.-Hippocrates, Decorum
Also Check: Stabilizing Spoon For Parkinson’s
Do Not Abruptly Discontinue Medications
Never abruptly discontinue antiparkinsonian medications. Serious reactions, such as neuroleptic malignant-like syndrome, can occur when antiparkinsonian medications are discontinued or the dose of levodopa has been reduced abruptly. This can result in a high fever, sweating, unstable blood pressure, stupor, muscular rigidity, and autonomic dysfunctions that can be life threatening.
What Are The Most Common Medicines Used To Treat Pd
Levodopa is the most commonly prescribed and most effective medicine for controlling the symptoms of PD, particularly bradykinesia and rigidity.
Levodopa is a chemical found naturally in our brains. When given as a medicine, it is transported to the nerve cells in the brain that produce dopamine. It is then converted into dopamine for the nerve cells to use as a neurotransmitter.
Sinemet is made up of levodopa and another drug called carbidopa. Levodopa enters the brain and is converted to dopamine while carbidopa prevents or lessens many of the side effects of levodopa, such as nausea, vomiting, and occasional heart rhythm disturbances. It is generally recommended that patients take Sinemet on an empty stomach, at least ½ hour before or one hour after meals.
There are two forms of Sinemet: controlled-release or immediate-release Sinemet. Controlled-release Sinemet and immediate-release Sinemet are equally effective in treating the symptoms of PD, but some people prefer the controlled release version. Ask your doctor which approach is best for you.
Dopamine agonists are medicines that activate the dopamine receptor. They mimic or copy the function of dopamine in the brain.
Parlodel®, Requip®, and Mirapex® are all dopamine agonists. These medicines might be taken alone or in combination with Sinemet. Generally, dopamine agonists are prescribed first and levodopa is added if the patient’s symptoms cannot be controlled sufficiently.
You May Like: What Is Dbs Surgery For Parkinson’s Disease
Medication Administration In The Management Of Parkinson Disease
A Position Paper Prepared by the Michigan Parkinson FoundationProfessional Advisory Board: May 2013
Persons with Parkinson disease consistently do not get their medications appropriately while hospitalized or in long term care facilities. Long-standing difficulties experienced center around the timing of medication administration and receiving drugs which interact with PD medications. The Professional Advisory Board of the Michigan Parkinson Foundation has studied this issue and joins several national and international Parkinsons disease organizations in recommending the development of programs and procedures to address care in these settings.
Thus far, the focus of programs to address these issues has targeted education of people with PD and their families to advocate for themselves when entering hospitals or long-term care facilities. This form of advocacy may assist in averting problems but does not address the root causes, which can add unnecessary stress to vulnerable individuals and families by forcing them to advocate for their own care. The Professional Advisory Board recommends that institutional level care should consider the following:
I must be given my medication promptly at the times specifiedThe timing of my medication is very important to help minimize my symptoms andoff times.For example: Sinemet often should be taken 30 minutes prior to or one hour after meals, because a meal sometimes delays the levodopa from reaching the brain.
How Can I Remember To Take My Parkinsons Medication On Time
There are lots of things you can do to help you get your medication on time.
For example, you could:
set an alarm on your phone or smart watch
get a family member to call you at the right time or arrange care visits around when you need to take your medication
use a pill box with sections for each day and time. You pharmacist can advise on the different ones available and we also sell them on the Parkinsons UK shop
Talk to your Parkinsons nurse if you are struggling to remember to take your medication. They can work with you to reschedule your treatment regime so that it fits around you.
Also Check: Signs Of Parkinson’s Disease