Hospital Patient Care for Parkinson’s

▪ medications are not given according to the patient’s predetermined schedule
▪  there is a “window” before or after prescribed times
▪  medications are not available from the pharmacy
▪  a sudden change of medications (including substitution), or stoppage of medications occurs

▪  the patient and/or caregiver be allowed to self-administer the patient’s Parkinson medications
▪  patients be permitted to use medications from their home supply, in their original containers
▪  the caregiver be present, where possible, to advocate for the patient.

▪  haloperidol (Haldol) and most neuroleptics

▪  prochlorperazine (Compazine), metoclopramide (Reglan),    promethazine (Phenergan) and droperidol (Inapsine)

▪  Selective MAO B inhibitors, such as rasagiline (Azilect), selegiline (l-deprenyl, Eldepryl), and selegiline HCL oral disintegrating (Zelapar) are contraindicated with commonly prescribed medications such as meperidine (Demerol) and tramadol (Rybix, Ryzolt, Ultram)

▪  pimavanserin (Nuplazid), quetiapine (Seroquel) and clozapine (Clozaril)

▪  trimethobenzamide (Tigan) and ondansetron (Zofran)

▪  To avoid potential interactions, it may be appropriate to hold the MAO B inhibitor for 2 weeks prior to surgery, and resume when pain is under control. If surgery is imminent, please use alternative medications for pain and check with the pharmacy or our neurologists for other potential drug interactions.

▪  Parkinson patients are prone to constipation. A diet high in fiber and water will be beneficial, and optimize medication absorption.

▪  A physical therapy evaluation prior to discharge can help the patient to move about safely and prevent falls.

▪  A speech language pathologist can perform a swallow evaluation should dysphagia develop.

▪  Should a nasogastric tube be required, carbidopa/levodopa 25/100 immediate release tablets can be crushed and administered via the tube.

Prior to surgery: patients should be allowed to take their Parkinson medications as close to the time of surgery as possible, and if safe to do so, with a sip of water.

After surgery: patients should resume taking their Parkinson medication as soon as it is safe to do so.

Please click here to view our PowerPoint slides from our February 2022 conference on the topic of Hospitalization & Parkinson’s.

When patients are in hospital, they are under the care of the hospital team. We’ve created a letter for you to share with your hospital medical providers with some basic information about Parkinson’s medications, and our contact info, to encourage them to consult with our team before making any changes to the patient’s medications.

Please download our letter and share with your medical providers in hospital and/or in rehabilitation. You can include it to your Parkinson’s Foundation Aware in Care Kit.

– comes on swiftly, possibly over one to two days, and symptoms can also vary considerably throughout the day. It mainly affects attention.
Can be caused by acute illness, and is reversible.

– is a gradual neurodegenerative process, and is generally not reversible. It mainly affects memory.