Tips For Taking Medication On Time
- If you take a number of different medications through the day you may find it helpful to use a pill timer. Resembling an alarm clock, this reminds you when to take the next dose.
- You can also buy various types of tablet organisers that have a compartment for each day, or are split into different sections for each day. Speak to your pharmacist or search on-line.
- If some doses are difficult to remember or at inconvenient times, talk to your doctor or pharmacist to see if timings can be adjusted.
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
Taking A Closer Look At Your Options
Since the drug levodopa was synthesized in the 1960s, levodopa in combination with carbidopa , has been the gold standard for treating the symptoms of Parkinsons. However, after several years of taking this medication some people experience dyskinesias, or involuntary writhing movements. This is sometimes referred to as levodopa-induced dyskinesias or LIDS. The fear of these side effects has led many clinicians and patients to avoid levodopa-carbidopa for as long as possible.
But some experts do not believe this levodopa phobia is warranted . In short, they say that levodopa can be considered as a potential first-line therapy in all age groups—although caution should be exercised in younger patients. In most cases, the dosage will start low then increase slowly, often in combination with other medications, to adjust to a persons changing condition.
Other first-line medications that can be used to control Parkinsons symptoms include drugs known as dopamine agonists and monamine oxidase inhibitors. Dopamine agonists provide relief by mimicking the action of dopamine within the brain, and monamine oxidase inhibitors help maintain motor control by slowing the breakdown of dopamine within the brain. These drugs can help younger patients buy some time before starting levodopa-carbidopa.
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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.
Why Is It Important That People With Parkinsons Get Their Medication On Time
Most drug treatments for Parkinsons work by topping up dopamine in the brain or acting as a substitute for dopamine. Without enough dopamine, the symptoms of Parkinsons appear.;
So if someone with Parkinsons doesnt get their medication on time, every time, this can mean their symptoms are not well controlled and it is more difficult to manage day to day.
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How Much Protein Do I Need
For optimal health, you need about a half gram of protein per pound of body weight every day. Take your weight in pounds and divide it by two to determine the grams of protein you need. For example, if you weigh 140 pounds, you should eat about 70 grams of protein. Since seniors are less efficient at processing protein, spreading protein consumption evenly throughout the day can improve absorption. If you eat three meals a day, divide the 70 grams by three. You should eat about 23 grams of protein in each meal. Of course, if you weigh more, eat more protein. If you weigh less, eat less protein.
You may think 20-25 grams of protein is a lot in one meal; however, if you plan ahead, incorporating the amount of protein you need is easy.
Breakfast
Breakfast is the time that most people dont eat enough protein. Just eating oatmeal or cereal with milk isnt enough. Add Greek yogurt, a slice of cheese, peanut butter on your whole-grain toast, an egg, or turkey sausage to increase protein.
Lunch
For lunch, two cups of chili with beans provide 20 grams of protein. Add some cornbread with some honey, and a half cup of milk or a dairy alternative, such as soy milk and you have met your protein requirement for lunch.; A grilled cheese sandwich with tomato soup and carrots sticks is another balanced meal idea.
Dinner
What About Other Medications
Its only levodopa that competes with amino acids to be absorbed in the small intestine. Dopamine agonists are taken up in a different way.
But food can impact on how we absorb any medications. And this is particularly true in people with Parkinsons.
In Parkinsons, the digestive tract can slow right down, causing constipation. And this slowness increases the risk of medication being broken down in the gut before it reaches the brain. Many people with Parkinsons find that delaying having a large meal until an hour or two after taking their medication can help with drug absorption and improve their symptoms.
However, its worth bearing in mind that some Parkinsons drugs can cause sickness if taken on an empty stomach. Eating a low protein snack when you take your dose may help to reduce this side effect.
If you have any concerns about your medication, are considering changing your diet, or are experiencing constipation, its important you speak with your health care professional, who will be able to help.
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Dealing With Side Effects Of Parkinsons Drugs
Its important to speak to your specialist or pharmacist if you notice anything unusual.
Changing or adding to your medication might help, and your specialist will be able to look into this.
For many people with advanced Parkinsons, medication may start to be reduced if side effects outweigh the benefits of taking medication.
But if some of the medication is reduced, you may find you get the benefits of the remaining ones, rather than the side effects.
If you experience side effects from your Parkinsons medication, you shouldnt stop taking it without guidance from your specialist.
Apart From Taking Medication What Else Can I Do To Help Myself
Parkinsons is a very individual condition and so each person will find their own way of coping and managing their symptoms.;
Often a combination of approaches is helpful, but before making any changes it is very important that you discuss with your doctor any proposed changes. You may need to adopt a trial and error approach to find what works best for you.;
Conventional and complementary treatments:
- Conventional Therapies, such as physiotherapy, occupational therapy, speech and language therapy
- Complementary therapies, such as aromatherapy, reflexology, yoga and Tai Chi
- Surgical treatments;such as Deep brain stimulation are also available but are not suitable for everyone and should only be undertaken after very careful consideration and discussion with your doctor.
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Advantages Of Comt Inhibitors
When used with levodopa, COMT inhibitors can reduce the daily off time and increase the on time.
In many cases, the dose and frequency of levodopa can also be reduced.
The terms on/off or motor fluctuations refer to the period when people can no longer rely on the smooth and even symptom control that their drugs once gave them.
Are There Any Possible Long
As with any medication, there can be long-term effects, although not every person who takes the medication will experience them. Each medication comes with an information leaflet which outlines possible effects so make sure that you read this. If you have any concerns, please discuss these with your doctor, health professional or pharmacist.
See also Managing medication.
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Some Disadvantages Of Comt Inhibitors
These drugs can increase the side effects caused by levodopa, notably dyskinesias , nausea and vomiting.
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.
What If I Forget To Take It
If you forget to take a tablet, take it as soon as you remember, unless it’s nearly time for your next dose. In this case, leave out the missed dose and take your next dose as usual.
Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten dose.
If you often forget doses, it may help to set an alarm to remind you. You could also ask a pharmacist for other ways to help you remember to take your medicine.
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What Does Current Guidance Say On This Issue
The NICE guideline recommends levodopa as a first-line treatment in the early stages of Parkinsons to control problems with movement if symptoms are affecting the quality of life. It does not discuss delayed treatment with levodopa.
If motor symptoms are not affecting the quality of life, the guideline recommends considering other drugs such as dopamine or monoamine oxidase inhibitors based on individual circumstances and preferences.
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:
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set an alarm on your phone or smart watch
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get a family member to call you at the right time or arrange care visits around when you need to take your medication
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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.
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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.
Cautions With Other Medicines
There are some medicines that do not mix well with co-careldopa.
Tell your doctor, specialist nurse or a pharmacist if you’re taking any of these medicines before you start taking co-careldopa:
- iron supplements
- tranylcypromine, phenelzine and isocarboxazid , or selegiline
- medicines for psychosis or schizophrenia, such as amisulpride, aripiprazole, haloperidol or risperidone
- anti-sickness medicines, such as metoclopramide or prochlorperazine
- medicines for high blood pressure , such as atenolol, ramipril or amlodipine
- medicines that make you sleepy, give you a dry mouth, or make it difficult to pee , including antihistamines, antidepressants and medicines for an overactive bladder
Many medicines have these anticholinergic effects, so check with a pharmacist if you’re not sure. They can affect how much co-careldopa your body takes in and stop it from working properly.
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How Do I Get An Ongoing Supply And Can I Obtain Medication If I Go To Other Countries
You will need to discuss with the doctor or specialist who prescribes your medication how you can get an ongoing supply. This will vary according;to where you live and the local services available, but usually arrangements are made for repeat prescriptions to be available at a pharmacy which is convenient for you.;
Your doctor will also be able to tell you how many weeks’ supply you can have in advance. Again this varies from country to country so you will need to ask about this.
Not all medications are licensed in every country, and some are known by different names so it is a good idea to check the local names of medications you use before you travel if you are going abroad.;
For information on availability at other international destinations it is best to check with your pharmacist, or local Parkinsons association. This website contains contact details for;Our members,;Other Parkinsons organisations.
As some medications are difficult to obtain in certain countries, and also in some cases, the quality may not always be of the highest standards, it is best to ensure that you take with you all the medications that you will need.
Carrying a few spare with you is always a good idea in case of any delays in your return. It is also advisable to carry a spare prescription with you just in case you do run out of medication while you are away.
For more information and useful suggestions on medication and travel, see;Travel and relocating.
Controlled Release Madopar And Sinemet
Controlled release preparations have the letters CR or HBS after the drug name.
These let the levodopa enter your body slowly instead of all at once. They can increase the time between doses.
They may be used when the dose of standard levodopa starts to wear off and the person taking it no longer feels the treatment is effective.
Controlled release options can sometimes reduce involuntary movements .
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Dopamine Agonist Withdrawal Syndrome
If you suddenly stop taking dopamine agonists, this can lead to dopamine agonist withdrawal syndrome, which can cause symptoms such as depression, anxiety or pain.
Any withdrawal from Parkinsons drugs needs to be done in a tapered way, under the supervision of a health professional.
Speak to your specialist for advice.
Case Study 42 Lindy Bradleys Experience Of Deep Brain Stimulation
Lindy was diagnosed with Parkinsons in 1999, aged 55.
I had reached almost the maximum medication I could be given but all these pills were losing their effect. Spasms in my legs were frequent and painful. I was unable to move or turn over in bed. I could no longer go out in the evenings because after about 8:30 p.m. I was unable to move apart from the endless shaking and jerking, which made dinner with friends or going to concerts impossible.
The prospect of deep brain stimulation was daunting and not without considerable risk. However, the alternative was far worse and therefore it was an easy decision to make. I couldnt go on as I was, not at 66 with four grandchildren I wanted to see grow up. I remember one evening at home when I couldnt even crawl on the floor. I just lay on the floor and cried.
During the operation I was fully awake and they kept me talking. My head was fixed in a frame so that I couldnt move and the surgeon drilled into my skull, standing behind me. The outcome of the operation seemed doubtful, but they went doggedly on for nearly seven hours until they were satisfied that they had got the electrodes deep enough into my brain. Afterwards when they switched me on, nothing happened. But two weeks later they tried again, with success. Thank goodness!
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The Reason Behind Medication Non
There are tens if not hundreds of reasons for missed doses. Low literacy, poor social and family support, inadequate access to pharmacy, the complexity of drug regimen, treatment requires help from others, unpleasant medications, hearing or visual impairment, lack of knowledge about the disease, lack of motivation, fear of dependence, depression, mental retardation, psychological stress, substance abuse. Family and social circle can help to overcome most of these problems and thus helping the person to stay motivated and stick to the therapy.
The problem of the missed dose is enormous. Physicians write almost 3.2 billion prescriptions each year. Thus nearly half of Americans report taking the prescription drug during last 30 days .