Resource spotlight: Perioperative Management of Parkinson’s Disease
May 20, 2022
Written by Bhawani Jain
This article was written and researched by a CSHP student member for Interactions
, our biweekly newsletter. Crafting these pieces not only helps students gain in-depth knowledge of specific conditions, treatments, and resources, it also helps them hone their skills in research, critical appraisal, evaluation, synthesis, and writing – all of which will serve them well in clinical practice. The Professional Practice Team works with the student to select topics that are of interest and utility to both the student and to you, the reader. We hope you enjoy this piece by one of our future colleagues! Let us know what you think: If you would like to provide any comments or constructive feedback for our students, please email us at practice@cshp.ca
Managing Parkinson’s Disease (PD) in the hospital can be a complex process that involves a variety of factors including drug interactions, timing of PD therapy, communication issues, and seeking alternative medications during surgery. This week’s “Resource Spotlight” shows resources to help pharmacists understand PD from a clinician and patient perspective, including management of PD drug therapy.
Parkinson Canada
Parkinson Canada is the Canadian national organization for Parkinson’s Disease. This website contains a variety of resources, especially for patients to learn about PD and how to manage their symptoms. There are plenty of handouts and fact sheets for patients and clinicians about topics pertaining to PD such as “
Young-Onset Parkinson's Disease: Advice for Physicians From Individuals Living With YOPD ”. One important resource is “
Managing My Parkinson’s Disease in Healthcare Settings ”. Though this resource is intended for patients, clinicians and pharmacists can understand the perspective of patients with PD and can remind patients about things they should mention or bring before arriving to the hospital for elective surgery. This resource also helps pharmacists understand the roles that other health professionals have in caring for a patient with PD. This resource also has a list of some of the medications that patients should avoid taking, which is also helpful for hospital pharmacists.
Canadian Guideline for Parkinson Disease
The Canadian Guideline for Parkinson Disease, published by the Canadian Medical Association Journal, is a resource for physicians, pharmacists, and other healthcare professionals to receive updated information about PD treatment in Canada. It highlights a summary of communication recommendations, diagnosis and progression of PD, various medication and procedure treatments, and ways to manage non-motor symptoms. This guideline contains a summary of key recommendations backed by empirical evidence in all areas of PD diagnosis, management, and treatment. This resource also contains a flowchart of PD diagnosis and progression and what clinicians can do at certain stages of the patient’s progression of PD.
American Parkinson Disease Association
The American Parkinson Disease Association (APDA) is the United States national organization for PD. Like the Canadian website, there are a variety of resources for patients and clinicians. There is also information about educational webinars and current clinical trials in PD treatment. A useful resource published by the APDA is a list of “
Medications To Be Avoided Or Used With Caution in Parkinson’s Disease ”. This is not an exhaustive list and only provides information for patients taking selegiline, rasagiline, or safinamide. However, it is a useful two-page resource that hospital pharmacists can quickly refer to for patients taking one of these medications so that drug interactions can be avoided.
Key Information for Hospital Pharmacists - Parkinson's UK
The Parkinson’s Disease Society of the United Kingdom has published a resource specifically for hospital pharmacists. It contains information about medication considerations, managing side effects with medications while avoiding drug interactions, how to manage swallowing issues for affected patients, drugs to avoid, ensuring that patients receive their medications on time, preparation of medications before the patient is admitted to hospital, and supporting the patient to take control of their medications post-discharge. It is a helpful and comprehensive resource that hospital pharmacists can consult to know more about how to best care for a patient with PD. The
Parkinson’s UK website also contains a separate set of resources specifically for healthcare professionals such as guidelines, clinical tools, assessments, and resources that can be provided to patients.
Research Articles for Perioperative Care
There are some research articles that can be helpful for hospital pharmacists. “
Managing Parkinson's disease during surgery ” is an article that focuses on preventing complications from missing dopaminergic medication during surgery for patients with PD. The article focuses on advance planning, appropriate prescribing, and specialist advice. There are also some examples of alternative enteric and non-enteric medications that can be administered to patients during surgery to prevent progression and worsening of PD while in the hospital. The American Journal of Medicine has also published a journal titled “
Perioperative Management of Patients with Parkinson’s Disease ” which contains a comprehensive list of recommendations, complications that can arise, and ways they can be prevented and managed. There is also information about how post-operative pain and psychiatric issues can be treated, while avoiding medications that can worsen PD.
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