The St. Louis APDA (American Parkinson Disease Association) Information & Referral Center, based at Washington University School of Medicine, recently published some wallet cards for medications to avoid or use with caution in those with Parkinson’s patients. Many of these same medications should be avoided or used with caution by those with Lewy body dementia and other atypical parkinsonism disorders.
As we aren’t sure how you can obtain these wallet cards, we thought we’d share the content here. It looks like these wallet cards were originally created by the Indiana Parkinson Center for Care.
The issues with some these medications are explained in four slides of this presentation by Johanna Hartlein, RN, clinical research coordinator/nurse practitioner, at Washington University:
https://d2icp22po6iej.cloudfront.net/wp-content/uploads/2017/08/PD_talk_caregivers_med_on_time_2017.pdf (see pages 50-53)
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Here’s the content of the wallet card:
Medications NOT TO BE USED by PD patients:
* Haloperidol (Haldol)
* Chlorpromazine (Thorazine)
* Thioridazine (Mellaril)
* Molindone (Moban)
* Perphenazine (Trilafon)
* Perpenzatine
* Thiothixne (Navane)
* Flufenzaine (Prolixin)
* Risperdal (Risperidone)
* Zyprexa (Olanzapine)
* Geodon (Ziprasidone)
* Abilify (Aripiprazole)
* Promethazine/Phenergan
* Prochlorperazine (Compazine)
* Trimethobenzamind Hydrochloride (Tigan)
* Metoclopramide (Reglan)
Medications TO BE USED WITH CAUTION in PD patients:
* Benzodiazepines: These are medications sometimes used for anxiety and sleep like Alprazolam (Xanas), Lorazepam (Ativan), Chlordiazepoxide (Librium), or Clonazepam (Klonopin). At low doses, these are sometimes very successful at treatmingREM sleep behavior disorder (thrashing around in one’s sleep/acting out in one’s dreams); however, they must still be used with caution.
* Dextromethorphan (DXM): commonly found in many cough and cold medicines. Many patients use this without any problem but still should use caution.
* Benadryl (Diphenhydramine): commonly found in many cough and cold medicines. Many patients use this without any problem but still should use caution.
* Narcotics: These are medicines used for pain like Hydrocodone, Hydromorphine (Dilauded), Meperidine (Demerol), Oxycodone (Oxycontin).
* Muscle Relaxers: These are medicines commonly used for pain or for strained muscles and may include Lorcet or Lortab, Percocet, or Darvocet.
These medications can worsen cognition and balance, particularly in elderly PD patients or PD patients with pre-existing thinking problems.