Medications

In 2023 Ann moved away from oral medications and on to the Duodopa Pump Therapy of delivering the Levodopa direct into the small intestine via a PEG-J tube.

But in the 11 years from 2012 to 2023 we had to cope with firstly learning about Parkinson's medications and then the process of actually managing them.

The notes below chronical that process.

Oral and Injectable Parkinson's Medications

This was a whole new world with a steep learning curve. This was not as simple as learning about aspirin or panadol and what they do.

While it is not strictly necessary to learn about the medications involved in managing Parkinson's symptoms, it does help to have an understanding of the medications regime.

And gaining that understanding was not a simple task.

Not only did we have to learn a whole new set of medication names and what they do but also what type of medication they are.

The compendium under the menu item Parkinson's Information has detailed sections on medications, and the table below gives some indication of the array of new terms to learn and understand.

Then there was the aspect of managing these medications which often have to be taken several times a day. Ann's Parkinson's medications had to be taken 6 times a day.

And there are the medications Ann has to take to manage the non-motor symptoms of Parkinson's. It means that pill type medications were taken 8 times a day and non-pill type ie liquids are taken normally twice a day.

You definitely need a good collection of pill containers.

Here is a selection of the ones we finally settled on. The main 7-day pill cases are filled once a month. That means there were 8 of them - a day and night set for each week for weeks 1 through 4.

Ann also used an Apomorphine Pen which delivers Apomorphine via direct injection to the body. The pen is similar to the ones used by diabetics to deliver insulin.

In addition to the pills and liquids and injections, Ann also had to apply a patch daily to administer slow-release Parkinson's medication.

A daunting regime that had to be followed religiously.

The Duodopa Pump

Unfortunately, the progression of Parkinson’s disease also affects how the body functions. One affect is the slowing of the digestive tract and erratic emptying of the stomach contents.

This affects the absorption of the medication causing fluctuations of Dopamine in the blood. These fluctuations result in unpredictable “off” times where the Parkinsons’s symptoms are no longer controlled.

This is often manifested in either excessive tremors or sustained periods of rigidity and impaired mobility.

Eventually a stage is reached where the “off” times are no longer controllable through oral medications resulting in a much-reduced quality of life – QOL.

An alternative therapy is then needed.

In general terms, current therapies are DBS for excessive tremors and the Duodopa Pump for rigidity and impaired mobility.

Ann’s QOL had deteriorated significantly through rigidity and lack of mobility, and this made her a suitable candidate for the Duodopa Pump

So, her pump was fitted in July 2023.

What is the Duodopa Pump.

Duodopa is designed as a continuous infusion of the standard Parkinson’s medication of Levodopa and Carbidopa into the intestine where it can be absorbed without the delay of erratic stomach emptying.

This means the level of Dopamine in the blood is more constant and some of the movement side effects are lower.

The pump is worn for around 16 hours a day, is taken off for showering and at night for sleeping. Medication kick in time in the mornings is usually around 10 – 15 minutes.

Ann has had a significant improvement in her QOL and is adamant that she will not go back to oral medications unless absolutely necessary.

For Ann, the Duodopa Pump has been a real life changer.

Main 7 day Pill cases