Before the test
Usually, three days prior to the test the patient should be asked to take the drug domperidone (Motilium) – an anti-emetic (anti-sickness medication).Taking domperidone is very important as APO-go (like Levodopa), may cause nausea, although this is often temporary and does not affect everyone.
On the day of the test, enough oral Pd medication (as agreed with the patient) to get the patient to the venue for the test should be taken. If possible, someone should accompany the patient to help with transport/walking.
The test
A pack of APO-go PENs is provided free of charge for the challenge. The needle used for the test is similar to those used with the APO-go Pump. These are short and extremely fine needles that are inserted into the subcutaneous tissue (just under the skin). Some patients report that they do not notice they are being injected.
On rare occasions, APO-go can cause a drop in blood pressure. The Pd nurse/specialist should monitor blood pressure throughout the test.
At each dose level the patient is asked to attempt a number of motor assessments, including standing and walking as well as manual dexterity – such as finger tapping.
The Challenge Test
| Pre-admission | Admission | Challenge | Time |
Domperidone 20mg tds for three days prior to and including the day of challenge Light breakfast Early am anti-Pd drugs |
"Off" state assessment: Record lying and standing blood pressure Take UPDRS III motor assessment, record score 12 metre timed walk |
Administer 1 mg s/c Re-assess Administer 3 mg s/c Re-assess Administer 5 mg s/c Re-assess Administer 6 mg s/c Re-assess Administer 7 mg s/c Re-assess No response at 7mg discontinue challenge. |
0 15 30 45 60 75 105 120 150 165 |