2 Statement of Intent 3 3 Scope 3 4 Definitions 3 5 Duties & Responsibilities 3 6 Consequences of missing medicines 4 Parkinson’s 7.0 disease management in patients secondary 4 Parkinson’s – care 7.1a) Patients with a compromised swallow or nil by mouth in 4 secondary care 7.1b) Hospital Surgery/NG patients (flow chart) 5 – 7.2 a) Patients with a compromised swallow or Nil by Mouth in 5 - 6 primary care 8.0 Nasogastric administration of Levodopa and Dopamine 6 - 7 agonist 9.0 Conversion table for transdermal delivery 8 10.0 Drugs to avoid in disease 8 Parkinson’s 11.0 Apomorphine guidelines 8 12.0 Contact details 9 13.0 References and acknowledgements 9 Appendix 1 Common oral medicines used in disease 10 Parkinson’s Appendix 2 Commonly used drugs to avoid in disease 11 Parkinson’s Appendix 3 Conversion algorithm 12 Appendix 4 Conversion charts 13 Appendix 5 Review and monitoring adherence to guideline 14 1. INTRODUCTION Clinical experience and audit has revealed that patients who are nil by mouth Parkinson’s (NBM) or experience swallowing difficulties are experiencing lack of consistency in their prescribing of medication. This guideline aims to standardise treatment with respect to appropriate timings, doses and formulations for patients.
2 Statement of Intent 3 3 Scope 3 4 Definitions 3 5 Duties & Responsibilities 3 6 Consequences of missing Parkinson’s medicines 4 7.0 Parkinson’s disease management in patients – secondary care 4 7.1a) Patients with a compromised swallow or nil by mouth in secondary care 4 7.1b) Hospital – Surgery/NG patients (flow chart) 5 7.2 a) Patients with a compromised swallow or Nil by Mouth in primary care 5 - 6 8.0 Nasogastric administration of Levodopa and Dopamine agonist 6 - 7 9.0 Conversion table for transdermal delivery 8 10.0 Drugs to avoid in Parkinson’s disease 8 11.0 Apomorphine guidelines 8 12.0 Contact details 9 13.0 References and acknowledgements 9 Appendix 1 Common oral medicines used in Parkinson’s disease 10 Appendix 2 Commonly used drugs to avoid in Parkinson’s disease 11 Appendix 3 Conversion algorithm 12 Appendix 4 Conversion charts 13 Appendix 5 Review and monitoring adherence to guideline 14 1. INTRODUCTION Clinical experience and audit has revealed that Parkinson’s patients who are nil by mouth (NBM) or experience swallowing difficulties are experiencing lack of consistency in their prescribing of medication. This guideline aims to standardise treatment with respect to appropriate timings, doses and formulations for patients.
Guideline%20-%20swallowing%20ACE%20Jan%202015.docx