Importance of timely administration of dopaminergic medications to improve Parkinson's patients' clinical outcomes
This article explores the challenges posed when ensuring the effective management of patients with Parkinson's in the secondary care setting. The evidence base around the appropriate timing and administration of medications is explored and highlights key themes in the literature to support best practice and raise clinical awareness. Failure to follow prescribed treatments for patients with Parkinson's can have significant implications for both patients and nursing care.
This article explores the implications of caring for patients with Parkinson's in secondary care. The evidence base is explored within the article to establish key considerations for the role of the nurse and to highlight risks associated with improper administration of time-critical medications.
Parkinson's was first described as the ‘shaking palsy’ and in the 1870s was named Parkinson's in honour of James Parkinson who was responsible for distinguishing Parkinson's from other diseases exhibiting similar symptoms (Goetz, 2011). According to the National Institute for Health and Care Excellence (NICE) (2017), there are no reliable tests that can distinguish Parkinson's from other diseases exhibiting similar symptoms, and its diagnosis is based upon clinical history and examination. Parkinson's is the second most common neurodegenerative disorder after Alzheimer's (Gerlach et al, 2011).
Dopamine is a chemical produced by neurons and is a type of neurotransmitter. The nervous system uses it to communicate between nerve cells to control movement, and it plays a role in the ability to think and plan (Cristol, 2021). Subsequently, the development of Parkinson's is related to the cell death of these neurons, causing a resting tremor, bradykinesia, rigidity, postural instability and swallowing difficulties (Ahlskog, 2009). Although Parkinson's is typically a slow progressive disorder, it does have a huge impact on patients' abilities and quality of life (Houghton et al, 2016). Currently, Parkinson's is regarded as idiopathic as its cause is unknown (Ahlskog, 2009). Donizak and McCabe (2017) highlighted that most people with Parkinson's first develop symptoms at around 60 years of age, suggesting that the disease primarily arises with increased age and longevity.
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