Complex PD - Duodopa
- oral therapy optimized?
- unsuitable for apomorphine?
- unsuitable for DBS?
Before Admission
- patient privided with duodopa literature
- information sheet
- video
- patient or carer able to cope with treatment
- patient discussed with
- PEG Team
- GP
- specialist commissioning
- abvie duodopa nurse specialist
- Informed consent taken for
- hospital admission
- naso-jejunal tube insertion
- PEJ tube insertion - if successful
- date given for admission to neurology ward
- screening for:
- B12 and serum homocysteine level
- nerve conduction studies
Admission
- patient admitted to 10 day assessment (Friday)
- naso-jejunal tube insertion
- home for weekend (If Possible)
- check x-ray on return to ward
- levodopa/carbidopa gel infusion comenced
- dose titration and oral medication adjustment
- naso-jejunal tube removed if no response
- PEG tube insertion if good response
Follow Up
- one week review at home or PD clinic
- ongoing input from Abbvie specialist nurse
- annual neuropathy screen
Key Contacts
Duodopa 24 hour support helpline - 0800 458 4410
JCUH PEG team - 01642 854845