A man with advanced Parkinson disease develops an ileus during admission. After 36 hours without co-careldopa he becomes profoundly rigid and

Question

A man with advanced Parkinson disease develops an ileus during admission. After 36 hours without co-careldopa he becomes profoundly rigid and obtunded, with temperature 39.5°C and CK 5,800 IU/L. Cultures do not suggest a new septic focus. Alongside supportive care, what is the most important immediate medicines action?

Accepted Answer

Restore equivalent dopaminergic treatment through a non-oral route selected with the Parkinson team

Answer

Use bromocriptine through a nasogastric tube as sole replacement for the usual dopaminergic regimen

Answer

Give intravenous dantrolene and restart co-careldopa once the creatine kinase begins to fall

Answer

Restart the previous oral co-careldopa regimen after gastrointestinal motility returns

Answer

Replace the omitted regimen with rotigotine 2 mg/24 hours while the ileus persists

PD – Hospital Medication Omission — SCE Neurology MCQ