• 2019 Senior Report Senior Report: Older Americans have more options for home care, but still struggling.

    The United Health Foundation has released results of a sweeping new study benchmarking the health of older adults. The America's Health Rankings® Senior Report was created in partnership with GAPNA to improve the health of America's seniors.

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  • 38th Annual GAPNA Conference

    October 3-5, 2019 at the Paris Hotel, Las Vegas, NV.

    Focused education; lasting connections, networking, free access to the GAPNA Online Library.

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  • AwardCall for Excellence Award Nominations

    The awards are: Emerging Chapter Award, Established Chapter Excellence Award, Special Interest Group Excellence Award, Excellence in Clinical Practice Award, Excellence in Community Service Award, Excellence in Education Award, Excellence in Leadership Award, and Excellence in Research Award.

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  • FREE continuing education credit is available for the following session:

    "Contemporary Heart Failure Management"

    (session captured at the GAPNA 2018 Annual Conference)


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  • AwardNew for GAPNA members: MCM Education

    GAPNA has partnered with a MCM Education to offer a series of CNE programs available to GAPNA members. "Alzheimer’s Disease Today and Tomorrow: Optimal Treatment and Collaborative Care," is the first program offered.

    What are the state-of-the-art strategies for managing the symptoms of Alzheimer’s disease? How can the multidisciplinary team work together to ensure timely intervention and optimal outcomes?

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  • Meet the Candidates for the 2019-2020 BOD!
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Clinical Pearls

Medication Considerations with Parkinson’s Disease: Case Study

by Tamatha (Tammy) Arms

A 72-year-old male patient living in an assisted living facility is diagnosed with Parkinson’s Disease.

He is independent with feeding himself after a meal set up and needs assistance with bathing and dressing at his baseline status. He is able to stand and pivot from bed to wheelchair and mobilizes throughout the facility independently in wheelchair.

An on-call provider, who was not familiar with this patient, was called over a holiday weekend and notified that staff were unable to bathe patient due to “agitated behaviors.”

Haldol® 0.5 mg 1-tab PO daily PRN for agitated behaviors was ordered. Haldol 0.5 mg PO was given by the medical techs daily for a week.

Patient developed psychomotor retardation, was unable to feed himself, and was unable to self-propel the wheelchair with overall worsening symptoms of Parkinson’s Disease. A family member called the provider’s office with concerns. An adult/geriatric and family psychiatric mental health nurse practitioner visited the patient. After an assessment and medication review, new orders were placed.

Haldol was discontinued due to the dopamine-blocking properties of conventional antipsychotics. This medication blocks D2 in the nigrostriatal pathway (Stahl, 2016). Therefore, it is useful in treating tics associated with Tourette’s syndrome but will worsen physical signs and symptoms of Parkinson’s Disease.

If this patient truly needs an antipsychotic medication, Seroquel® 25 mg is the medication of choice. Seroquel blocks 2A receptors which causes enhanced dopamine release in certain areas of the brain, reducing motor side effects (Stahl, 2016). Seroquel is an atypical antipsychotic and will treat psychosis which may be displayed as “agitated behaviors,” while not causing the side effects conventional antipsychotics will for a person with Parkinson’s Disease.

Tamatha (Tammy) Arms, DNP, PMHNP-BC, NP-C
armst@uncw.edu

Reference
Stahl, S. (2016). Essential psychopharmacology prescriber’s guide (5th ed.). San Diego, CA: Cambridge University Press

Plan your trip to the nation’s capital during GAPNA’s Annual Conference, September 26-29, 2018 by checking out all the things to do, places to eat, and ways to have fun.

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