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Time-Critical Parkinson's Medication — SCE Palliative Medicine MCQ

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EasyNon-Malignant Palliative CareTime-Critical Parkinson's MedicationSCE Palliative Medicine

A 75‑year‑old woman with advanced Parkinson’s disease on levodopa/carbidopa is admitted to the hospice. Her usual medication times are 07:00, 11:00, 15:00, 19:00 and 23:00. The hospice drug round is at 08:00, 12:00, 18:00 and 22:00. What is the critical issue?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Parkinson’s medications should remain scheduled at the patient’s usual times

Explanation lettering: D = shown as A · A = shown as B · B = shown as C · C = shown as D

NICE quality standard QS164 states that adults with Parkinson’s disease in hospital or a care home must take levodopa within ±30 minutes of their individually prescribed administration times, as delays increase risk of acute akinesia or neuroleptic malignant syndrome ([nice.org.uk](https://www.nice.org.uk/guidance/QS164/chapter/quality-statement-4-levodopa-in-hospital-or-a-care-home?utm_source=openai)). Additionally, NHS Specialist Pharmacy Service defines levodopa as a time‑critical medicine due to its short half‑life: early or delayed doses exceeding 30 minutes may lead to substantial harm or sub‑optimal therapy ([sps.nhs.uk](https://www.sps.nhs.uk/articles/defining-time-critical-medicines/?utm_source=openai)). Option B uniquely recognises this critical requirement. Options A and C wrongly assume flexibility, and D and E are clinically inappropriate and harmful.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer/palliative-care