Setting up the Crono® APO-go® and PAR apomorphine infusion pumps

When oral Parkinson’s medications can no longer keep symptoms steady, continuous subcutaneous apomorphine infusion helps smooth motor fluctuations throughout the day. The Crono APO-go and Crono PAR pumps deliver apomorphine continuously for more consistent symptom control.

This video from our Administering Parkinson’s Therapy with Pumps and Pens series walks you through the complete setup—showing how to prepare, fill, and start each device.

You’ll learn how to:

• Choose the appropriate syringe size and apomorphine concentration
• Program dosing flow rates
• Assemble and connect the syringe, adapter, and infusion line
• Prepare and secure a subcutaneous injection site
• Start the infusion and confirm operation

This lesson provides a clear, step-by-step walkthrough of setting up the Crono APO-go and Crono PAR apomorphine infusion pumps for continuous Parkinson’s therapy.
 

Deepen your understanding of advanced and device-assisted treatments in our Parkinson’s Masterclass: Advanced Therapeutics course.

Overview of Crono Crono APO-go and Crono PAR apomorphine infusion pumps

[00:00]
The Crono APO-go and Crono PAR pumps are manual syringe drivers used for the continuous subcutaneous infusion of apomorphine. They are compatible with 20 and 50 mL syringes. The choice between these syringe sizes can depend on factors such as the patient’s specific medication needs, dosage requirements, and duration of infusion.

Apomorphine syringe options and concentration settings

[00:23]
The 50 mL syringe can be filled with 13 different concentrations of apomorphine, allowing the dose to be individually tailored to the patient and helping to avoid possible skin reactions that can occur with higher concentrations. The dose is programmed in milliliters, and a conversion table is used to convert milligrams to milliliters.

Apomorphine dosing and flow rate programming

[00:46]
For example, the 50 mL syringe is filled with four apomorphine prefilled syringes and 10 mL of sodium chloride. A flow rate from 6 a.m. to 12 p.m. should be 6 mg/hour. The concentration is 4 mg/mL, and the flow rate in mL/hour is then 1.5 mL/hour. Up to three different flow rates can be programmed, as well as a bolus dose for extra doses throughout the day. The programmed values can be locked so the patient can’t change them.

Preparing the Crono apomorphine infusion pumps

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The pump is powered by a battery. Before setting up the pump, disinfect your hands and work surface. Place all of your materials on the table, including a special tray to hold all of the materials, the Crono APO-go and Crono PAR pump, apomorphine in prefilled syringes, a plastic medication syringe, an infusion set, an adapter, and tape. 

Preparing the syringe and pump assembly

[02:05]
Place the pump in the tray. Open the plastic syringe package, and then pull the stopper out and push it back in once to loosen it. Unscrew the plunger to remove it from the syringe. Place the syringe on the pump and turn it to connect the syringe to the pump. Now screw the adapter onto the syringe.

Filling the pump syringe with apomorphine

[02:42]
Take the syringe prefilled with apomorphine, place it on the adapter, and slowly fill the plastic syringe. Repeat this step with a second syringe prefilled with apomorphine to fill the 20 mL plastic syringe with the medication. Now remove the adapter and screw the infusion line onto the plastic syringe.

Preparing the injection site

[03:43]
Disinfect the injection site—so the lower abdomen, inner thigh, upper arm, under the shoulder blades, or in the flanks. Insert the needle at the injection site and remove the grip on the back. Secure the needle and line with tape.

Starting the apomorphine pump infusion

[04:09]
Press the on/off button to start the infusion. You will hear a beep once it’s started. The patient can give themselves an extra dose directly after preparing the pump by pressing the d/P button. The infusion line does not have to be primed because this is a subcutaneous application, and a dry needle protects against skin irritation. Finally, put the pump in the carrying bag.