Apomorphine is a medication used to alleviate symptoms of Parkinson's disease (PD). Parkinson's disease is a chronic nervous system disorder that results in loss of muscle control, balance, and other problems with movement. Patients with this disorder will usually be prescribed other medications in addition to apomorphine. Apomorphine, which is a dopamine agonist, is used specifically to relieve symptoms during “off” episodes.
“Off” episodes in PD means that the primary drugs a person is taking have begun to wear off. Some “off” episodes may also occur at random. During these episodes, the patient's symptoms will resurface, such as problems with speech, walking and other movements. This drug is somewhat limited, however, as it cannot prevent these episodes from occurring.
There is no oral form of this medication. Apomorphine must be injected subcutaneously, or under the skin. Since patients will typically have trouble controlling their movements, it is likely that a caregiver will need to administer the injection.
Apomorphine is given to patients in a glass cartridge. Needles and an injector pen are required to administer the shot. It is essential to use a new, sterile needle each time, and used needles should be disposed of in a puncture-proof container.
The person administering the injection must wash his hands carefully. He will then cleanse the area of skin with an alcohol swab. Apomorphine may be injected into the upper leg, upper arm, or stomach. The caregiver should use a different injection site each time, and avoid using an area of skin that is broken, red, swollen, or otherwise abnormal.
Caregivers must carefully follow all the directions given with the injector pen. They will insert a new cartridge into the pen, and then attach the needle. It is also essential to prime the pen to remove any air bubbles. This is done by adjusting the dosage knob to 0.1 milliliters (mL) and pressing the injection button for five seconds. Should a small amount of medication not be released from the pen, this step must be repeated.
The person administering apomorphine must also set the correct dosage using the dial. Dosages for each patient will be different. The doctor will start the patient with a smaller dose, and then provide instructions for increasing the dose. Should the patient not need apormorphine for a week or longer, the caregiver should contact the doctor for the proper amount of medication to use. Those who may administer the injection must do so in the presence of the doctor for the first time, to ensure they understand the proper procedure.
Patients and caregivers should be alerted to the possible side effects of apomorphine. These can include nausea, vomiting, and difficult urination. Shortness of breath, rapid heartbeat, and hallucinations are uncommon, but potentially serious. Abnormal behavior, changes in vision, and confusion may also occur. The patient should receive immediate medical care if any side effects appear severe.