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Antiemetics in Parkinson's — GPhC CRA MCQ

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EasyCNS TherapeuticsAntiemetics in Parkinson'sGPhC CRA

A 72-year-old man with Parkinson's disease is prescribed domperidone 10 mg three times daily for nausea. He is also taking co-beneldopa. Why is domperidone preferred over metoclopramide in this patient?

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Correct answer: D — Domperidone does not cross the blood-brain barrier significantly, so it does not worsen parkinsonian symptoms

Domperidone is a peripherally acting dopamine antagonist that does not significantly cross the blood-brain barrier. This means it can treat nausea without blocking dopamine receptors in the basal ganglia, which would worsen parkinsonian symptoms. Metoclopramide and prochlorperazine cross the blood-brain barrier and antagonise central dopamine receptors, making them contraindicated or best avoided in Parkinson's disease.

Reference: BNF; NICE NG71 Parkinson's Disease