Pharmacological treatment of palliative care patients with Parkinson’s disease

Żylicz, Zbigniew

doi:10.5603/pmpi.2022.0007

Cited by 2 publications

(4 citation statements)

References 28 publications

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“…Opioids can be particularly useful in managing not only pain in the last days of life, but also shortness of breath. When unable to swallow tablets, alternative methods of administering opioids like syringe drivers have been used with success ( Campbell et al, 2010 ; Butt et al, 2019 ; Żylicz, 2022 ).…”

Section: Review Of Management Recommendations For Inpatient Pwp At Eolmentioning

confidence: 99%

“…If psychosis persists and further dose reduction will cause bothersome motor impairment, antipsychotics can be added. First generation antipsychotics should be avoided ( Żylicz, 2022 ). Among atypical antipsychotics, quetiapine and clozapine are the preferred agents.…”

Section: Review Of Management Recommendations For Inpatient Pwp At Eolmentioning

confidence: 99%

“…Pimavanserin and preferred atypical antipsychotics (clozapine and quitepine) can be safely used in this population. Cholinesterase inhibitors may be discontinued to reduce pill burden ( Żylicz, 2022 ).…”

Section: Review Of Management Recommendations For Inpatient Pwp At Eolmentioning

confidence: 99%

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End of life care of hospitalized patients with Parkinson disease: a retrospective analysis and brief review

Bhansali,

Assaedi,

et al. 2023

Front. Aging Neurosci.

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BackgroundTowards the end of life (EOL), persons with parkinsonism (PwP) have complex needs and can present with unique palliative care (PC) challenges. There are no widely accepted guidelines to aid neurologists, hospitalists, or PC clinicians in managing the symptoms of PwP at EOL. We examined a population of PwP at EOL, aiming to describe trends of in-hospital management and utilization of PC services.MethodsAll PwP admitted to two hospitals during 2018 (N = 727) were examined retrospectively, assessing those who died in hospital or were discharged with hospice (EOL group, N = 35) and comparing them to the main cohort. Their demographics, clinical data, engagement of multidisciplinary and palliative services, code status changes, invasive care, frequency of admissions, and medication administration were assessed.ResultsAmong the EOL group, 8 expired in hospital, and 27 were discharged to hospice. Forty-six percent of EOL patients received a PC consultation during their admission. The median interval from admission to death was 37 days. Seventy-seven percent had a full code status on admission. Compared to hospice patients, those who expired in hospital had higher rates of invasive procedures and intensive care unit transfers (41% vs. 75%, in both variables), and lower rates of PC involvement (52% vs. 25%). The transition of code status change for the EOL group from Full code to Do Not Resuscitate (DNR) occurred at a median 4–5 days from admission. For patients that passed in the hospital, the median days from transition of code status to death was 0(IQR 0–1). Levodopa dose deviations were frequent in both EOL and non-EOL group, but contraindicated medications were infrequently administered (11% in EOL group vs. 9% in non-EOL group).ConclusionOur data suggest a low utilization of PC services and delayed discussions of goals of care. More work is needed to raise awareness of inpatient teams managing PwP regarding the unique but common challenges facing PwP with advanced disease. A brief narrative review summarizing the suggested management of symptoms common to hospitalized PwP near EOL is provided.

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Section: Review Of Management Recommendations For Inpatient Pwp At Eolmentioning

confidence: 99%

Section: Review Of Management Recommendations For Inpatient Pwp At Eolmentioning

confidence: 99%

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End of life care of hospitalized patients with Parkinson disease: a retrospective analysis and brief review

Bhansali,

Assaedi,

et al. 2023

Front. Aging Neurosci.

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“…The motor behaviour of the animals was assessed using the open field test on days 1, 7, and 14 after the treatment. The behavioural scoring system was used to evaluate motor behaviour [17].…”

Section: Animal Selection Animal Group Division Animal Group Dosingmentioning

confidence: 99%

Development and Evaluation of Novel Apomorphine and Quetiapine Combinational Formulation for Parkinson’s Disease in Rat: New Era (Possibilities) for Pre – Clinical Protocol Concept Review

Patel¹

2023

Preprint

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Parkinson's Disease (PD) is a neurodegenerative disorder that affects the motor system of the human body. Currently, the available treatments are limited and often have undesirable side effects. In this context, the aim of this study was to develop a novel combinational formulation of Apomorphine and Quetiapine and evaluate its efficacy in a rat model of PD. The formulation was prepared using the solvent evaporation technique and characterized for its physicochemical properties. The in-vitro drug release was evaluated using the Franz diffusion cell method, and the pharmacokinetics of the combination was studied in rats. The behavioural and biochemical parameters were evaluated in the rats using the Rotarod, pole test, and biochemical assays. The results showed that the developed formulation had satisfactory physicochemical properties and exhibited sustained drug release. The pharmacokinetic studies showed that the combination exhibited a longer residence time than the individual drugs. The behavioural and biochemical parameters showed that the combination was effective in improving motor function and reducing oxidative stress. In conclusion, the developed Apomorphine and Quetiapine combination formulation showed promising results in improving motor function and reducing oxidative stress in rat model of PD. Further studies are required to evaluate the safety and efficacy of the developed formulation in humans.

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Pharmacological treatment of palliative care patients with Parkinson’s disease

Cited by 2 publications

References 28 publications

End of life care of hospitalized patients with Parkinson disease: a retrospective analysis and brief review

End of life care of hospitalized patients with Parkinson disease: a retrospective analysis and brief review

Development and Evaluation of Novel Apomorphine and Quetiapine Combinational Formulation for Parkinson’s Disease in Rat: New Era (Possibilities) for Pre – Clinical Protocol Concept Review

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