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Dopamine antagonist in Parkinson's — GPhC CRA MCQ

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ModerateCNS TherapeuticsDopamine antagonist in Parkinson'sGPhC CRA

A 72-year-old patient with Parkinson's disease develops nausea after starting an antibiotic. The GP asks which antiemetic is least likely to worsen Parkinsonian symptoms. The patient takes co-beneldopa. What is the most appropriate alternative?

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

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Correct answer: A — Domperidone

Domperidone has peripheral dopamine antagonist activity and is less likely to worsen Parkinsonism than centrally acting dopamine antagonists. Metoclopramide, prochlorperazine and antipsychotics can exacerbate Parkinsonian symptoms. Cardiac risk and patient-specific contraindications should still be considered.

Reference: BNF; NICE CKS