Apomorphine infusion is a therapy used to control motor fluctuations in patients with advanced Parkinson disease. The therapy is considered effective in reducing OFF time, which is periods when other Parkinson’s disease medication has no effect, and is administered continuously with a pump.
Apomorphine infusion, which is a clinically proven revolutionary therapy, is recommended by UK, European and US Parkinson’s guidelines to be considered as an alternative and should be considered before more conventional Brain Stimulation therapies. Despite the name ‘Apomorphine’, the therapy doesn’t not contain any form of morphine. Like any other dopamine agonists ( Pramipexole, Ropinorole ) it’s a dopamine agonist.
A brain chemical known as dopamine, which is a neurotransmitter, is used by the nervous system to send signals between the nerve cells and to communicate on what the body feels or acts. Parkinson’s disease occurs when the nerve cells are affected causing dopamine not to be released naturally as it should, thus resulting in an individual not being able to balance or coordinate movement. This can result in shaking hands, having muscle stiffness, experiencing a hunched over posture, and having difficulty in walking.
Apomorphine infusion acts as a booster of the dead or impaired dopamine levels to restore these functions. Dopamine is also used in the functioning of the basal ganglia found in the brain that controls the body movements.
Reasons Apomorphine Infusion
When there are motor fluctuations due to abnormalities in the release of levodopa (initial medication used to regulate the level of dopamine) cause of erratic gastric emptying and poor levodopa absorption oral levodopa causes unpredictable/predictable motor fluctuations causing stiffness, freezing and dskinesias
Apomorphine Infusion for People with Parkinson’s Disease
How it Works
Apomorphine infusion is a solution that is transparent and clear with no particles. It is administered continuously through a small portable battery-operated pump that comes with a pre-filled reservoir. The pump has a tubing which comes with a needle at the end, which is inserted into the fatty layer of the skin and not through the veins to deliver the medication. Usage of the pump is directed by your interventional neurologist.
The administration of the apomorphine is done over several hours, whereby the dose is adjusted to suit the needs of the patient.
Before the initial infusion of apomorphine, the effects of Parkinson’s Disease in an individual are examined by the doctor. This is to ensure that any hypotension (low blood pressure) is regulated if it occurs. The apomorphine infusion is then delivered into the subcutaneous (fatty) layer below the skin and not intravenously (through the vein). This is done in an outpatient setting. A directive for the other doses is given of when and who to do the administration, such as a relative or the patient, as it can be done by anyone other than the doctor or nurse.
The patient or the care giver is requested to record the amount administered on each dose, uin order to keep track on when to replace the cartridge.
Precautions to Take
While undergoing apomorphine infusion therapy, there are certain precautions to be taken. These include:
- Thoroughly reading and reviewing all the instructions given and asking any questions if need be
- Not sharing the apomorphine infusion pump with anyone
- Not using the apomorphine if it has expired or contaminated. The solution may look different in color and may turn green or cloudy and have particles
- Not operating heavy machinery after the dose as it may cause drowsiness and dizziness
- Avoid drinking alcohol so as to avoid more complications.
Side Effects of Apomorphine Infusion
Apomorphine infusion therapy comes with various side effects. These include:
- Nausea and vomiting
- Soreness or bruising at the infusion area
- Pain, redness or a prickly feeling at the site of the infusion.
- Skin nodules
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