4.4 Describe how to manage side effects of medication for Parkinson’s disease

This guide will help you answer 4.4 Describe how to manage side effects of medication for Parkinson’s disease.

Parkinson’s disease medication helps to manage symptoms such as tremors, stiffness, and slow movements. While these medicines can improve quality of life, they can cause side effects. These side effects can vary depending on the type of medication, the dose, and how the person’s body reacts.

Many people with Parkinson’s disease are prescribed medicines that increase or mimic dopamine in the brain. Dopamine is a chemical messenger that helps control movement. Common medicines include Levodopa, dopamine agonists, and MAO-B inhibitors.

Common side effects may include:

• Nausea
• Vomiting
• Feeling lightheaded or dizzy
• Hallucinations
• Confusion
• Sleepiness
• Sudden sleep episodes
• Increased movement or dyskinesia
• Impulse control problems such as gambling, overspending, or overeating

Each side effect requires careful management. This protects the health and safety of the person and helps them to gain the most benefit from their treatment.

Working with Healthcare Professionals

Managing side effects always starts with clear communication between the person, care staff, family, and healthcare professionals. Care staff must record side effects accurately and report them in line with the care plan and organisational policy.

Key actions include:

• Notifying the GP or specialist about changes in behaviour or physical symptoms
• Following instructions from doctors, nurses, or pharmacists about dosage changes
• Never adjusting medication without medical advice
• Asking for regular medication reviews

A medication review allows doctors to decide if the medicine should be changed, reduced, or swapped for an alternative. This can help reduce side effects while still controlling Parkinson’s symptoms.

Managing Gastrointestinal Side Effects

Stomach-related side effects like nausea, sickness, and constipation are common with Parkinson’s medicines such as Levodopa and dopamine agonists. These can be distressing and may reduce how regularly someone takes their treatment.

Ways to manage these include:

• Taking medication with a small snack if permitted by the prescriber to reduce nausea
• Avoiding high-protein meals at the exact time of taking Levodopa, as protein can affect its absorption
• Drinking enough water throughout the day to help with digestion and bowel function
• Including more fibre in meals to reduce constipation
• Using prescribed anti-sickness medication if needed

Care workers should watch for changes in appetite or weight. If the person loses weight or refuses food often, this should be reported promptly.

Managing Low Blood Pressure and Dizziness

Some Parkinson’s medicines can lower blood pressure. This can make a person feel faint when standing up quickly. The term for this is orthostatic hypotension.

Strategies to manage include:

• Encouraging the person to rise slowly from sitting or lying down
• Suggesting that they sit for a few moments before standing
• Reporting any fainting episodes to the healthcare team
• Wearing support stockings if recommended by a doctor
• Increasing fluid intake if medically safe
• Dividing large meals into smaller portions to avoid sudden blood pressure drops after eating

These measures help reduce the risk of falls and injuries.

Managing Sleep-Related Side Effects

Medicines such as dopamine agonists can cause sudden sleep episodes or severe daytime sleepiness. This can put the person and others at risk, for example, if they drive or operate machinery.

Possible steps include:

• Encouraging the person to avoid driving if they experience sudden sleep attacks
• Reporting increased daytime sleepiness to a healthcare professional promptly
• Adjusting activities to avoid situations where drowsiness could be dangerous
• Supporting a regular sleep routine to improve rest at night

Some people may also have vivid dreams or nightmares. If these disturb sleep, the doctor may adjust medication timing.

Managing Dyskinesia

Dyskinesia means uncontrolled, jerky movements. It often occurs after long-term use of Levodopa. It is caused by fluctuating levels of dopamine in the brain.

Ways to manage dyskinesia:

• Recording the times of day when symptoms occur
• Alerting the healthcare team so medication timing can be adjusted
• Supporting the person to take part in gentle physical activity to maintain mobility and reduce stiffness
• Ensuring the person has a safe environment to reduce injury risk

Managing dyskinesia often involves balancing medication benefits against its risks.

Managing Mental Health Side Effects

Some people may develop hallucinations, paranoia, or confusion. This is more common in older adults, people with advanced Parkinson’s, or those on high doses of medication.

Care workers should:

• Remain calm and supportive when a person is distressed
• Avoid arguing about hallucinations, as this can increase anxiety
• Report all changes in behaviour promptly
• Work with healthcare professionals who may alter the prescription or reduce the dose
• Reduce environmental triggers such as poor lighting which may worsen visual hallucinations

Confusion can also be caused by infections or dehydration, so physical health should always be checked.

Managing Impulse Control Disorders

Dopamine agonists can sometimes cause impulsive behaviours such as gambling, overspending, binge eating, or hypersexual behaviour. These can damage relationships and finances.

Care actions:

• Observing and recording changes in behaviour
• Discussing concerns with the person in a non-judgemental way
• Reporting patterns of risky behaviour to healthcare professionals
• Involving family or trusted people to provide support and help put safeguards in place
• Requesting a medication review

These behaviours can be very distressing for the person and their family, so quick action is important.

Supporting Adherence to Medication

Managing side effects is linked closely to encouraging the person to keep taking their medicine as prescribed. If side effects are not managed, a person may stop taking it, which can worsen Parkinson’s symptoms.

Care workers can support adherence by:

• Helping to organise medication in dosette boxes or blister packs
• Checking the person understands the purpose of each medicine
• Offering encouragement and reassurance if they feel anxious about side effects
• Sharing positive outcomes achieved by staying on treatment, such as improved movement or mood

Safe Practices in Medication Support

Any care worker who assists with medication should follow agreed procedures. This includes:

• Storing medication safely and securely
• Recording each dose given, refused, or missed
• Wearing gloves if handling medication directly, unless the medicine is in a container
• Washing hands before and after giving medication
• Following infection control measures
• Checking the person’s identity before giving medication
• Confirming the correct medicine, correct dose, correct person, correct time, and correct route (oral, patch, etc.)

This reduces risks of errors which can worsen side effects or cause harm.

Working with the Care Plan

Every person with Parkinson’s will have different side effects and different ways to manage them. The care plan is the central document that outlines agreed approaches. Actions for workers include:

• Reading the care plan before giving medication
• Recording any side effects or incidents immediately in line with policy
• Following any special instructions such as medication to be taken with food
• Communicating changes to supervisors or nurses

Care plans should be updated regularly to reflect changing needs and responses to medication.

Education and Awareness

Understanding medication side effects helps care workers to notice problems early. Training should cover:

• Common Parkinson’s medicines and their side effects
• Strategies to manage or reduce side effects
• When to seek urgent medical help
• How to support the person’s independence and dignity while addressing side effects

Examples of urgent situations include sudden worsening of symptoms, signs of severe allergic reaction, or signs of neuroleptic malignant syndrome, which is a rare but serious side effect.

Monitoring and Record Keeping

Accurate records are important for safe care. Observations to record include:

• Time and date of medication given
• Any side effects seen, such as sickness, dizziness, or mood changes
• Any missed or refused doses
• Actions taken, such as reporting to the nurse or calling the GP
• Any changes in movement or speech
• The person’s own comments about how they are feeling

This information supports decision making and allows healthcare professionals to make informed changes to treatment.

Encouraging Physical and Emotional Wellbeing

Some side effects are easier to manage if the person maintains general health. Support can include:

• Encouraging light physical activity suited to their abilities
• Helping with balanced meals to manage weight and energy levels
• Supporting regular social interaction to reduce feelings of isolation
• Providing reassurance and emotional support to reduce anxiety around side effects

When a person feels supported, they are more likely to continue treatment and report problems early.

Risk Assessment

Side effects can increase risk of injury or illness. For example, dizziness increases fall risk, and confusion increases the likelihood of unsafe decisions. Each person’s risks should be assessed regularly, and measures to reduce them should be in the care plan.

Examples of adjustments:

• Removing trip hazards at home
• Installing grab rails in bathrooms
• Providing a walking aid if advised by a physiotherapist
• Scheduling activities at times when the person is more alert and steady

Involving Family and Carers

Family members often notice changes before professionals do. They can provide valuable insight on mood changes, risk behaviours, and movement patterns. Workers can encourage family involvement by keeping them informed (with the person’s consent) and sharing advice from healthcare professionals on how to support the person at home.

Regular communication can prevent misunderstandings and help everyone work together to manage side effects.

Final Thoughts

Managing side effects from Parkinson’s disease medication is an ongoing process that requires observation, communication, and a clear plan. Every person responds differently to medication. Side effects can affect physical, emotional, and social aspects of life. By noticing changes early and reporting them, the care team can adapt support and prevent more serious problems.

Good care means balancing relief from Parkinson’s symptoms with the impact of the medication. When staff, family, and healthcare professionals work together, the risks can be reduced. This makes it possible for the person to benefit from treatment while keeping side effects to a manageable level.