to tremors

Other Drugs: Antihistamines are sometimes prescribed with the anticholinergics to inhibit dopamine uptake; bromocriptine mesylate, a dopamine antagonist, is ordered to stimulate dopaminergic receptors.


Promote independence in the patient. Encourage maximum participation in self-care activities. Allow sufficient time to perform activities, and schedule outings in late morning or in the afternoon to avoid rushing the patient. Reinforce occupational and physical therapy recommendations. Use adaptive devices as needed. If painful muscle cramps threaten to limit the patient's mobility, consider warm baths or muscle massage.

To facilitate communication, encourage the Parkinson's disease patient to speak slowly and to pause for a breath at appropriate intervals in each sentence. Teach deep-breathing exercises to promote chest expansion and adequate air exchange. Be alert to nonverbal clues, and supplement interactions with a communication board, mechanical voice synthesizer, computer, or electric typewriter.

To maintain nutritional status, monitor the patient's ability to chew and swallow. Monitor weight, intake, and output. Position the patient in the upright position for eating to facilitate swallowing. Offer small, frequent meals; soft foods; and thick, cold fluids. Supplemental puddings or nutritional shakes may be given throughout the day to maintain weight.

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Help the patient maintain a positive self-image by emphasizing her or his abilities and by reinforcing success. Encourage the patient to verbalize feelings and to write in a journal. Help the patient maintain a clean, attractive appearance. Caregivers may need a great deal of emotional support. Explore strategies for long-term care with the patient and significant others.

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