Systematic ReviewResearchMedication SafetyPatient Education

Selective D1/D5 partial agonists improved Parkinson motor outcomes but increased adverse effects

Neurological sciences (PubMed)Aug 15, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A GRADE-assessed meta-analysis found that selective D1/D5 dopamine partial agonists improved motor outcomes in early and levodopa-treated Parkinson disease, while adverse effects and treatment discontinuation were more frequent than with placebo.

What NurseJet pulled from the source

Seven randomized double-blind trials included 1,540 participants, with five entering quantitative synthesis. Tavapadon improved the combined MDS-UPDRS Parts II and III score and added 1.09 hours of good ON-time per day, but nausea, dizziness, overall adverse events, and discontinuation were more common.

Why this matters for nurses

Neurology nurses track mobility, daily function, ON/OFF patterns, adherence, falls, and treatment intolerance. The findings highlight potential motor benefit while reinforcing that dizziness, nausea, discontinuation, and uncertain neuropsychiatric advantages require structured assessment and medication follow-up.

Bedside takeaway

Track motor benefit and tolerability together; placebo-controlled improvement does not establish superiority to other dopamine agonists.

How This Applies in Practice

Use this when: Monitoring a patient with Parkinson disease who has been prescribed a selective D1/D5 dopamine partial agonist.

On your shift

Document baseline mobility, activities of daily living, ON/OFF timing, falls, cognition, behavior, sleepiness, nausea, dizziness, and adherence.
Trend motor function and good ON-time alongside adverse effects, orthostatic symptoms, fall risk, and reasons for missed doses or discontinuation.
Use teach-back for the prescribed schedule and findings that require contacting the neurology team, including behavior change or unsafe sleepiness.

Keep in mind: The evidence is short-term and placebo-controlled and does not authorize independent medication changes. Follow the neurology protocol, facility medication policy, and provider orders.

Key takeaways

The review included seven placebo-controlled trials with 1,540 participants; five trials contributed to quantitative synthesis.
In early disease, tavapadon improved the combined MDS-UPDRS Parts II and III score by 10.55 points versus placebo across two trials.
In levodopa-treated participants with motor fluctuations, good ON-time increased by 1.09 hours per day across two trials.
No outcome had high-certainty evidence, no trial used an active comparator, and no trial followed participants beyond 27 weeks.

Practice implications

For a prescribed selective D1/D5 partial agonist, establish baseline motor and functional status, track ON/OFF timing and falls, and assess nausea, dizziness, somnolence, behavior, and adherence. Escalate suspected adverse effects or functional decline without independently changing therapy.

Limitations & cautions

Only five of seven trials entered quantitative synthesis, no outcome reached high certainty, no study used an active comparator, and follow-up did not exceed 27 weeks. Evidence for impulse-control disorders and somnolence was very low certainty, so an advantage over D2/D3 agonists remains untested.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

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Neurological sciences (PubMed)

Neurological sciences (PubMed). "Efficacy, safety and certainty of evidence for selective D1/D5 dopamine receptor partial agonists in Parkinson's disease: a systematic review, meta-analysis and GRADE assessment".

Open original source

https://pubmed.ncbi.nlm.nih.gov/42601529/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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Renal failure (PubMed)Sep 7, 2026Research Article

A single-center retrospective cohort found that approximately one quarter of laboratory-defined acute kidney injury cases on internal medicine wards were not documented, particularly when maximal creatinine was lower.

Med-SurgAI summaryReview source

Research ArticleResearchQuality ImprovementAI summary · original source linked below

Among 161 adult hospitalizations meeting serum-creatinine criteria for acute kidney injury, 39 cases (24.2%) were undocumented. Length of stay and in-hospital mortality did not differ significantly by documentation status.

Key takeaways

In the 149 hospitalizations with a demonstrable creatinine change, 33 cases (22.1%) were undocumented.
Higher maximal creatinine was associated with lower adjusted odds of underdocumentation.
The study did not test whether a detection or documentation intervention improves care or outcomes.

Why this matters on shift

A smaller creatinine rise may receive less attention even when it meets the study's laboratory definition of acute kidney injury, which can affect how renal risk is communicated across the inpatient team.

Bedside takeaway

Trend ordered renal-function results and communicate clinically important changes through local escalation and documentation workflows.

Nursing implications

Trend ordered renal-function results and communicate clinically important changes through the care team according to local escalation and documentation workflows.

Limitations & cautions

Abstract-only summary. This was a retrospective, single-center study of 161 hospitalizations; urine-output criteria and reliable preadmission creatinine values were unavailable, and the reference creatinine method may affect case classification.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Renal failure (PubMed). Underdocumentation of laboratory-defined acute kidney injury in internal medicine wards: a retrospective cohort study.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

Pediatric emergency care (PubMed)Sep 7, 2026Research Article

A double-blind randomized trial found no reduction in vomiting or faster oral tolerance with intravenous pantoprazole versus placebo in children with acute gastroenteritis and persistent vomiting after ondansetron.

Peds EmergencyAI summaryReview source

Research ArticleResearchMedication SafetyAI summary · original source linked below

The trial randomized 100 children. Vomiting episodes and oral tolerance at 6 and 12 hours did not differ significantly, while median hospital stay was 2 days with pantoprazole and 1 day with placebo.

Key takeaways

The median participant age was 14 months, and 67% of participants were male.
Oral tolerance at 12 hours was 86% in both groups.
The longer stay associated with pantoprazole requires cautious interpretation because this was a single-center trial.

Why this matters on shift

The trial does not support empiric intravenous proton-pump inhibition for persistent vomiting in pediatric acute gastroenteritis after ondansetron.

Bedside takeaway

Clarify the indication for empiric acid suppression and keep hydration and oral-tolerance assessment central to care.

Nursing implications

Prioritize the ordered hydration and oral-tolerance plan, document ongoing emesis, and clarify the indication before administering empiric acid suppression.

Limitations & cautions

Abstract-only summary. This was a single-center study of 100 children in Tehran, and the abstract does not describe adverse events or explain why hospitalization was longer in the pantoprazole group.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Pediatric emergency care (PubMed). Effect of Intravenous Pantoprazole on Clinical Outcomes in Pediatric Acute Gastroenteritis: A Placebo-Controlled RCT.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

European heart journal (PubMed)Sep 6, 2026Research Article

In the pragmatic TARGET-D randomized trial, vitamin D dosing titrated to a serum target did not significantly reduce the composite of death, recurrent myocardial infarction, heart-failure hospitalization, or stroke after myocardial infarction.

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Among 630 participants followed for an average of 4.2 years, major cardiovascular events occurred in 15.7% with targeted vitamin D management and 18.4% with usual care (hazard ratio 0.85, 95% CI 0.58 to 1.24; P=0.40).

Key takeaways

At baseline, 87% of participants had a 25-hydroxyvitamin D level of 40 ng/mL or lower.
The primary composite outcome and the individual outcomes of death, heart-failure hospitalization, and stroke were not significantly different.
A lower recurrent-MI rate was a secondary finding and should not override the nonsignificant primary result.

Why this matters on shift

The trial cautions against presenting targeted vitamin D supplementation as a proven strategy for reducing major cardiovascular events after myocardial infarction.

Bedside takeaway

Present vitamin D as prescribed supplementation, not as a replacement for established post-MI secondary prevention.

Nursing implications

Reinforce the prescribed secondary-prevention plan and avoid implying that vitamin D replaces therapies with established post-MI benefit.

Limitations & cautions

Abstract-only summary. The trial included 630 participants, 78.1% were men, the primary confidence interval included benefit and no benefit, and individual secondary outcomes were not the primary endpoint.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

European heart journal (PubMed). Targeted vitamin D supplementation and major adverse cardiovascular events after myocardial infarction: the TARGET-D trial.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

Exact source links

More updates for this clinical area

One in four laboratory-defined AKI cases went undocumented on medicine wards

IV pantoprazole did not improve vomiting or oral tolerance in pediatric gastroenteritis

Targeted vitamin D did not significantly reduce major cardiovascular events after MI