Parkinson's Disease Anaesthesia — FRCA Final MCQ

Instant feedback + full explanation. One question, done properly.

ModeratePreoperative AssessmentParkinson's Disease AnaesthesiaFRCA Final

A 72-year-old man with Parkinson's disease controlled with levodopa/carbidopa is undergoing elective total hip replacement. Which of the following perioperative drugs is specifically contraindicated because of his Parkinson's disease?

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

Reveal the answer and explanation

Correct answer: D — Droperidol

Droperidol is the correct answer. Its UK SmPC explicitly lists Parkinson's disease as a contraindication. It is a butyrophenone dopamine-receptor antagonist; central dopaminergic blockade opposes levodopa therapy and may worsen rigidity, bradykinesia and other extrapyramidal symptoms. Neuroleptic malignant syndrome has also been reported. Fentanyl is not contraindicated, although rapid or large doses can cause muscular and chest-wall rigidity. Ondansetron does not antagonise dopamine receptors and is suitable in a patient taking levodopa/carbidopa; it is contraindicated with apomorphine, which this patient is not receiving. Paracetamol and sevoflurane are not contraindicated solely because of Parkinson's disease. Antiparkinsonian medication should be administered at the prescribed times and unnecessary perioperative interruption avoided.

Reference: Electronic Medicines Compendium, Droperidol Panpharma 2.5 mg/ml solution for injection, SmPC sections 4.3 and 4.5, updated 2025. https://www.medicines.org.uk/emc/product/7310/smpc