OPTIMAL Calculator

A Guideline for the OPTIMAL management of inpatients with Parkinson's Disease.

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Medicines management is crucial in the care of the patient with Parkinson’s Disease (PD) when they are admitted to hospital either electively or in an emergency.

Missed doses can impair patients’ swallow, increase their risk of aspiration, render them immobile and prone to falls and fractures, and – at worst – lead to Neuroleptic Malignant-Like Syndrome, which can lead to coma and death.

This guideline aims to help non-specialist clinical staff to better manage patients with PD when they are admitted to hospital in an emergency, better plan for elective admissions and direct you to sources of specialist support.

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Calculator 1,
for patients who can have an NG Tube

If your patient has poor swallow or is Nil By Mouth, insert a nasogastric (NG) tube if appropriate.

Use this calculator to convert the patient's usual Parkinson's tablets to dispersible or liquid preparations, which can be given via the tube. Arrange SALT review as soon as possible.

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Calculator 2,
for patients who cannot have an NG Tube

If your patient cannot have enteral medications, either because they cannot have a nasogastric (NG) tube or due to gastrointestinal (GI) failure, use this calculator to convert their usual Parkinson's Disease (PD) medication to a transdermal patch.

We would recommend that Apomorphine injections should only be initiated by a PD specialist.

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