When I Am In The Hospital Why Don’t I Always Get My Medications On Time
Hospitals and hospital pharmacies have their own dosing schedules. A medication written for “TID ” may be given at 7 AM – 3 PM – 11 PM or some other standard schedule. Many hospitals may have a policy that permits nurses to give medications at times different from the scheduled time. This policy is a practical compromise because nursing staffs are busy and each nurse cares for multiple patients. Such a policy provides nurses time to complete their scheduled duties and allows flexibility in case of emergencies on the ward. As a result, it may seem that patients with Parkinson’s disease receive their medications at random times.
How can such a situation be remedied? First, make sure that the drug schedule, with specific times, is written into the doctor’s orders. Check that the physician knows when it should be given. Bring with you the complete list of your medications with the correct dosage. Talk with your nurse about the importance of receiving your medications on time. Explain that, without the medications, you can be immobile or uncomfortable and that the medications allow you to move around independently. You may know more about Parkinson disease than the doctor and the staff, so it is your responsibility to help them understand your situation. While you will still need to be somewhat flexible, sharing your knowledge can alleviate many problems. The staff wants patients to be well cared for during their stay.
A Critical Reappraisal Of The Worst Drugs In Parkinsons Disease
What are the worst drugs for Parkinsons disease patients? Couldnt a simple list be assembled and disseminated to the Parkinson community? Recently Ed Steinmetz, an experienced neurologist in Ft. Meyers, FL pointed out to me, a list approach published in the Public Citizen Newsletter . The approach was to list every drug associated with a single confirmed or unconfirmed symptom of Parkinsons disease or parkinsonism. Parkinsons disease is defined as a neurodegenerative syndrome , whereas parkinsonism encompasses a wider net of drug induced and other potential causes. In parkinsonism symptoms are similar to Parkinsons disease, but patients do not have Parkinsons disease. Patients and family members confronted with a simple drug list approach may falsely conclude that most medicines are bad for Parkinsons disease, and that any medicine may cause parkinsonism. This concept is in general, incorrect. Although the approach is well-meaning, it is in need of a major revision, as Parkinsons disease and parkinsonism are too complex to summarize by simple lists. In this months column I will try to summarize the key information that patients and family members need to know about the worst pills, for Parkinsons disease and parkinsonism.
A Florida Parkinsons Treatment Blog by Michael S. Okun, M.D.
UF Center for Movement Disorders & Neurorestoration, Gainesville FL
Recently Fred Has Found His Eyes Are Closed Involuntarily Most Of The Time Though If He Makes An
You dont think, Oh, it would be nice to have my eyes closed now?
The mask that is the expressionless face, typical of many people with Parkinsons, probably distresses the people who have to live with it more than it embarrasses the person who has it. It tends to be the position the face falls into when not actively doing something else. Lack of facial expression can be hard for the family.
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Signs Of Parkinsons Disease
In 1817, Dr. James Parkinson published An Essay on the Shaking Palsy describing non-motor, as well as, motor symptoms of the illness that bears his name. Parkinsons is not just a movement disorder, explained Dr. Shprecher. Constipation, impaired sense of smell, and dream enactment can occur years before motor symptoms of Parkinsons. The latter, caused by a condition called REM sleep behavior disorder, is a very strong risk factor for both Parkinsons and dementia . This has prompted us to join a consortium of centers studying REM sleep behavior disorder.
What You Can Expect
Parkinson does follow a broad pattern. While it moves at different paces for different people, changes tend to come on slowly. Symptoms usually get worse over time, and new ones probably will pop up along the way.
Parkinsonâs doesnât always affect how long you live. But it can change your quality of life in a major way. After about 10 years, most people will have at least one major issue, like dementia or a physical disability.
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Memory Or Thinking Problems
Having issues with thinking and processing things could mean your disease is progressing. Parkinsons is more than a movement disorder. The disease has a cognitive part as well, which means it can cause changes in the way your brain works.
During the final stage of the disease, some people may develop dementia or have hallucinations. However, hallucinations can also be a side effect of certain medications.
If you or your loved ones notice that youre getting unusually forgetful or easily confused, it might be a sign of advanced-stage Parkinsons.
What It Looks Like:
You feel a general level of physical or mental exhaustion that stretches beyond normal tiredness. Just starting any workout is an accomplishment due to your utter lack of energy and motivation. When you do manage to exercise, youre wiped out. You may notice walking seems incredibly difficult, due to heaviness in your legs or extreme freezing. Exercise is such an endeavor that youre tempted to just avoid it altogether.
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Q: What Happens If I Get A Cough From Covid
A: You are correct that it is important to pay attention to possible medication interactions. Cough and cold medications containing dextromethorphan, pseudoephedrine, phenylephrine, and ephedrine need to be avoided only if you are on a monoamine oxidase inhibitor such as rasagiline, selegiline or safinamide. Be sure to check the product ingredients before purchasing, and if you are unsure ask your doctor or pharmacist to clarify which brands/medications should be avoided. If you are on an MAOI, any other cold medication without these ingredients is safe for you to take. If you are not taking an MAOI, any cold medication is suitable for you.
Here is the list of medications to avoid in PD.
Is Parkinsons Disease Fatal
It is important to understand that PD is not considered a fatal condition. As is the case with Alzheimers disease and other forms of dementia, complications and a patients comorbid conditions are more life-threatening than PD itself. For example, because Parkinsons affects movement, balance and coordination, a patients risk of falling increases as the disease progresses. Falls are notoriously dangerous and a leading cause of injury and death among older adults. Difficulty swallowing, known as dysphagia, is another complication that can develop at any point throughout ones journey with PD, and this can cause aspiration pneumoniaanother leading cause of death in patients.
Read:Dysphagia: How to Help a Loved One Eat and Drink Safely
Because a persons overall health is an important factor in how Parkinsons progresses, lifestyle choices are vitally important for prolonging both functionality and longevity. Regular exercise, a healthy diet, careful management of preexisting conditions and prevention of new medical issues is crucial.
It is important to work with a well-rounded medical team to understand PD symptoms, explore treatment options and devise a personalized care plan for improving ones overall health, maintaining a high quality of life, and preventing complications.
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Can Parkinsons Disease Be Prevented
Unfortunately, no. Parkinsons disease is long-term disease that worsens over time. Although there is no way to prevent or cure the disease , medications may significantly relieve your symptoms. In some patients especially those with later-stage disease, surgery to improve symptoms may be an option.
Q: I Received The Covid
A: The vaccine is certainly able to cause short term side effects of fatigue, aches and even fever. There isnt extensive data yet on how it affects PD symptoms, just anecdotal data. For some people, PD symptoms are worse in the short term. This does not mean that your PD has progressed, and I would expect that you will return to your previous baseline in the next few days. I would talk with your neurologist about your worsened tremor as well.
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Living With Parkinson Disease
These measures can help you live well with Parkinson disease:
- An exercise routine can help keep muscles flexible and mobile. Exercise also releases natural brain chemicals that can improve emotional well-being.
- High protein meals can benefit your brain chemistry
- Physical, occupational, and speech therapy can help your ability to care for yourself and communicate with others
- If you or your family has questions about Parkinson disease, want information about treatment, or need to find support, you can contact the American Parkinson Disease Association.
How To Cope Up With Parkinsons Disease
Parkinsons disease is progressive and eventually affects every aspect of life from social engagements to work and normal life routines. The gradual loss of independence may be difficult but being well informed about the disease may reduce the anxiety to a large extent. There are various support groups that offer valuable information to patients with such disease and how to cope with the same. These groups provide emotional support and also advice the patients with regard to finding experienced doctors, therapists and other related information.
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Why Can’t I Take My Own Medications In The Hospital Why Do They Substitute Some Medications For Me
The nursing staff must have control of your medications. This is a safety issue and is standard hospital policy.
Some patients may be taking medications that are not stocked in that hospital’s pharmacy. In such situations, the hospital physician may have to prescribe substitute medications. If you want to take your own medications, bring them from home in their original bottles and give them to the nurses, who will dispense your medications. In some hospitals and outpatient surgical facilities, the doctor can write an order for patients to take their own medicines under supervision.
How Does Parkinsons Progress
Parkinsons is a chronic and slowly progressive disorder. This means that symptoms normally appear slowly and develop gradually over time. The stage at which symptoms appear, speed at which they progress and the severity of those symptoms will vary from person to person. The most important point is that Parkinsons affects everyone differently.
There are a wide range of symptoms, but it is highly unlikely that you will experience every possible symptom. Some of the early symptoms of Parkinsons include handwriting changes, reduced sense of smell, tiredness and constipation. As Parkinsons progresses symptoms will change over time, and new symptoms will emerge. It can take many years for symptoms to progress to a point where they cause problems.
Ultimately symptoms will begin to impact on your day to day life. Many symptoms are related to physical movement, so you may find that walking becomes difficult. You may also experience non-movement symptoms such as mood changes, disrupted sleep or difficulty communicating. As these symptoms worsen it may become difficult to manage all of your daily activities.
Currently, there is no known way to slow the progression of Parkinsons. However, medications and other treatments can help to effectively manage your symptoms. To ensure the effectiveness of medications, they will need to be reviewed regularly by your specialist or doctor.
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What Medications Are Used To Treat Parkinsons Disease
Medications are the main treatment method for patients with Parkinsons disease. Your doctor will work closely with you to develop a treatment plan best suited for you based on the severity of your disease at the time of diagnosis, side effects of the drug class and success or failure of symptom control of the medications you try.
Medications combat Parkinsons disease by:
- Helping nerve cells in the brain make dopamine.
- Mimicking the effects of dopamine in the brain.
- Blocking an enzyme that breaks down dopamine in the brain.
- Reducing some specific symptoms of Parkinsons disease.
Levodopa: Levodopa is a main treatment for the slowness of movement, tremor, and stiffness symptoms of Parkinsons disease. Nerve cells use levodopa to make dopamine, which replenishes the low amount found in the brain of persons with Parkinsons disease. Levodopa is usually taken with carbidopa to allow more levodopa to reach the brain and to prevent or reduce the nausea and vomiting, low blood pressure and other side effects of levodopa. Sinemet® is available in an immediate release formula and a long-acting, controlled release formula. Rytary® is a newer version of levodopa/carbidopa that is a longer-acting capsule. The newest addition is Inbrija®, which is inhaled levodopa. It is used by people already taking regular carbidopa/levodopa for when they have off episodes .
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What Is Parkinsons Disease
Parkinsons disease is a nervous system disease that affects your ability to control movement. The disease usually starts out slowly and worsens over time. If you have Parkinsons disease, you may shake, have muscle stiffness, and have trouble walking and maintaining your balance and coordination. As the disease worsens, you may have trouble talking, sleeping, have mental and memory problems, experience behavioral changes and have other symptoms.
How Do I Prevent Falls From Common Hazards
- Floors: Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its usual place.
- Bathroom: Install grab bars and non-skid tape in the tub or shower. Use non-skid bath mats on the floor or install wall-to-wall carpeting.
- Lighting: Make sure halls, stairways, and entrances are well-lit. Install a night light in your bathroom or hallway and staircase. Turn lights on if you get up in the middle of the night. Make sure lamps or light switches are within reach of the bed if you have to get up during the night.
- Kitchen: Install non-skid rubber mats near the sink and stove. Clean spills immediately.
- Stairs: Make sure treads, rails, and rugs are secure. Install a rail on both sides of the stairs. If stairs are a threat, it might be helpful to arrange most of your activities on the lower level to reduce the number of times you must climb the stairs.
- Entrances and doorways: Install metal handles on the walls adjacent to the doorknobs of all doors to make it more secure as you travel through the doorway.
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Q: I Am On Amantadine For My Pd I Know That It Is Also An Anti
A: We do not have evidence that amantadine acts against COVID-19, so you should continue to assume that it is not effective against this coronavirus.
Tips and Takeaways
- Most people who are infected with COVID-19 will recover completely. However, older adults and those with underlying medical issues such as advanced PD are at an increased risk of developing serious outcomes from COVID-19 as compared to those who are younger and healthier.
- Three COVID-19 vaccines have been approved in the US.
- Getting vaccinated reduces your chances of contracting COVID-19, but those who are vaccinated can still contract COVID-19.
- Vaccination is about 90% effective in protecting against severe illness, hospitalization, and death, even for the new Delta variant
- Continue to monitor CDC guidelines for information on COVID-19.
- Talk with your doctor about any concerns you have about COVID-19 or COVID-19 vaccines.
Do you have a question or issue that you would like Dr. Gilbert to explore? Suggest a Topic
Dr. Rebecca Gilbert
APDA Vice President and Chief Scientific Officer
What Causes Parkinson Disease
Parkinson disease arises from decreased dopamine production in the brain. The absence of dopamine makes it hard for the brain to coordinate muscle movements. Low dopamine also contributes to mood and cognitive problems later in the course of the disease. Experts don’t know what triggers the development of Parkinson disease most of the time. Early onset Parkinson disease is often inherited and is the result of certain gene defects.
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What Doctors Expect Longer
While other patients struggle to do the same, clinicians such as Gilbert stress there is good reason to believe that such lingering effects of COVID-19 will ultimately be surmountable with time. We don’t think that the medical illness necessarily alters the course of PD, or makes more neurons die, so we typically expect people to return to their baseline, she says. Knowing that is important, as it gives people encouragement that the illness did not set their PD on a different course, even though it may seem that way in the short term. In the meantime, doctors recommend staying connected with peer support groups and exercise classes virtually, as much as is possible, to help with recovery.
Though recovery may take longer than patients would like, Tanner says there is cause for optimism: This is a really resilient community. People are strong and they’re fighters.
Cheryl Platzman Weinstock is a contributing writer who covers health and science research and its impact on society. Her work has appeared in the New York Times, NPR and Kaiser Health News.
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