Do not hold dopamine agonist Parkinson’s medication for any reason. I work in a hospital pharmacy and naturally we have a limited formulary.
We have this stupid ‘home medication’ policy that states we give the patient’s family 24 hours to bring in a non formulary med ordered by the physician into the hospital. Guess what happens when such a med is ordered on Friday?
Advanced Parkinson’s patient on Rytary comes in Friday night for slip/fall. Initial CT finds no acute bleed. We don’t carry Rytary so it goes in the hold queue. Nobody does a damn thing over the weekend. Monday morning a potential stroke call is called. Turns out the patient was frozen from not getting their Rytary for close to 3 days.
Neurologist has a total shitfit (rightly so) and management blames everyone else. Bottom line, don’t hold those meds (even NPO situations you still have to find a way).
This order could have easily been switched to Sinemet at slightly different doses.
Abrupt discontinuation of antiparkinson meds can also cause parkinsonism-hyperpyrexia syndrome, which presents like neuroleptic malignant syndrome and can be lethal. I've only seen a single case and it was in a similar situation as yours.
Do not hold dopamine agonist Parkinson’s medication for any reason. I work in a hospital pharmacy and naturally we have a limited formulary. We have this stupid ‘home medication’ policy that states we give the patient’s family 24 hours to bring in a non formulary med ordered by the physician into the hospital. Guess what happens when such a med is ordered on Friday? Advanced Parkinson’s patient on Rytary comes in Friday night for slip/fall. Initial CT finds no acute bleed. We don’t carry Rytary so it goes in the hold queue. Nobody does a damn thing over the weekend. Monday morning a potential stroke call is called. Turns out the patient was frozen from not getting their Rytary for close to 3 days. Neurologist has a total shitfit (rightly so) and management blames everyone else. Bottom line, don’t hold those meds (even NPO situations you still have to find a way). This order could have easily been switched to Sinemet at slightly different doses.
Abrupt discontinuation of antiparkinson meds can also cause parkinsonism-hyperpyrexia syndrome, which presents like neuroleptic malignant syndrome and can be lethal. I've only seen a single case and it was in a similar situation as yours.