Hi all, a elderly PD patient goes to ER for a trip and fall on a wednesday everything is fine, thursday 1 hour hip surgery went great, gets demerol in the PACU, becomes confused, late thursday, friday and saturday gets a IV push with Haldol, sunday crashes with respiratory failure, mild heart attack, arrhythmia and is developing aspiration Pneumonia taken to ICU, advances his PD to stage 5, gets dysphagia dies 5 days later with fatal heart attack, advanced pd, aspiration Pneumonia and dysphagia.
Patient lived alone with stage 2 pd, drove a car, took walks, shopped prior to incident.
Haldol is contradicted in PD, PDR says don't take Haldol if allergic or have PD, FDA says no IV haldol let alone to push it, patient was on parcopa which is adverse with Haldol. also no informed consent on the Haldol, california law says informed consent for Haldol and the elderly. I cant see a doctor telling the patient/guardian I would like to give a med contradicted in your illness and push it, which is not approved either, so I can calm you.
After the guardian heard of the Haldol signed a physical restraint consent form, then came the Ativan
Questions:
1. Should the RN catch the medication error? should the RN check to make sure informed consent is in place.
2. Why would a internal med doctor order Haldol for a PD patient if the outcome is to calm him? and signs off on med eval that the patient has PD, does not consult neurologist.
3. The Haldol induced everything research said it would in a none PD patient, 10 fold in the PD patient who already lacks dopamine.
A. Who is at fault the Doctor for the order or the RN for following it?
B. No one, he would have died anyway elderly get aspiration Pneumonia often from surgery.
C. No matter what else the Haldol did as it said and advanced the PD and froze the patient
And finally many of you are RN's if a doctor tells you to push a drug IV and you know it is contradicted would you do it anyway?
Can a nurse tell a doctor he is wrong?
Someone had to hit "Ignore" or "Override" on the MC-1 when it flagged parcopa/levodopa and Haldol.
And the levaquin he was given is adverse with the Haldol
I attended a dinner meeting where a prominent Toledo Doctor spoke and I [chatted] at length with him following the presentation. He urged EVERYONE diagnosed with Parkinsons Disease to contact EVERY doctor they see and add HALDOL (Haloperidol is a typical antipsychotic drug) to the list of meds they are allergic to. He said when asked what the side effects are, tell them "IT WILL KILL ME" and that should get medical staff attention. Said it 'blocks' the dopamine and the patient "FREEZES", among other life-threatening reactions.
A very nice RN stated this:
I am an RN and I have had PD for 5 years.
It is unfortunate how misinformed and uneducated many healthcare professionals are regarding PD. Steps are being taken to improve this by developing continuing education for nurses.
It is so important that we as patients and caregivers arm ourselves with as much knowledge as possible because we are often the ones who must educate the staff who are caring for us or our loved ones.
It is important to note that while Haldol is contraindicated for PD so are many other antipsychotics as well as other commonly used medications. Below is a list of drugs contraindicated in PD. It is by no means a comprehensive list but the best one I have found online. It is from the pdasd.org website (PD Assoc of San Diego). APDA also has a nice pamphlet which also includes other drugs that interact with PD meds. Please obtain a copy from APDA or other PD organization or print this list and carry it with you.
ANTI-PSYCHOTIC
Haldol
Trilafon
Thorazine
Stelazine
Prolixin, Permitil
Navane
Mellaril (High-Dosage)
Loxitane
ANTI-DEPRESSANTS
Triavil Combination of Perphenazine & Amitriptyline
Ascendin
*Nardil
*Parnate
ANIT-VOMITING
Compazine
Reglan
Torecan
BLOOD PRESSURE; POST-OPPERATION
Serpasil
Raudixin
Rauverid
Wolfina
Harmony-1
Moderil
Rauwiloid
NARCOTIC/ANALGESIC
*Demerol
OTHER MEDICATIONS
Aldomet
Dilantin
Lithium
BuSpar
*Eldepryl should never be taken with Demerol or any other opiod, MAI, or elective
serotonin reuptake inhibitor such as Zoloft, Paxil, Prozac, or tricyclic antidepressants.
Thank You All So Much For Your Comments and Insight...
I am a PD advocate and want to help PD sufferers when they enter the hospital and I realize in some deceases our doctors and nurses cannot possibly know everything about certain afflictions, the more we all know the better we can all heal the ill, both patient and caregiver..........
