MUE 09: Parkinson's Disease in Acute Care
** This bulletin supersedes MUE 01 **
- It is CRUCIAL NOT TO STOP Parkinson’s Disease (PD) medications for any significant length of time as there is a risk of neuroleptic malignant-like syndrome which may be fatal.
- Ensure early referral to the PD team to minimise risk of medication administration problems.
- When a patient does not have an individual supply of PD medication, supply should be sought immediately via the local main holding areas of PD medications across NHSGGC. Refer to NHSGGC guidance “PD medication stock list, acute hospitals” on StaffNet for details or contact pharmacy.
- For nil by mouth (NBM) patients, alternative routes need to be considered immediately. Seek advice from a PD specialist. Refer to NHSGGC “PD NBM guidance” on StaffNet, clinical pharmacist or Medicines Information for clinical advice if PD specialists are unavailable.
- In PD patients undergoing surgery, consider the full NBM period including pre-operative preparation, the total duration of surgery and post-operative recovery. Ensure advance planning where possible to avoid missed doses.
- Co-careldopa (Duodopa®) intestinal gel must be continued in patients established on treatment. Refer to NHSGGC guidance “Duodopa Monograph for maintaining co-careldopa (Duodopa®) intestinal infusion treatment in patients admitted to hospital” on StaffNet for details.
- Apomorphine must be continued in patients established on treatment. Refer to NHSGGC guidance “Apomorphine Subcutaneous Infusion Treatment in Patients Admitted to Hospital” on StaffNet for details.