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Antiemetic choice in Parkinson's disease — GPhC CRA MCQ

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HardGastro-intestinal TherapeuticsAntiemetic choice in Parkinson's diseaseGPhC CRA

A 70-year-old man prescribed metoclopramide for nausea has Parkinson's disease treated with co-beneldopa. He has developed worsening tremor after two doses. What is the most appropriate alternative?

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Correct answer: D — Discuss domperidone suitability with the prescriber

Metoclopramide and several dopamine antagonists can worsen Parkinsonism. Domperidone may be considered because it has less central dopamine blockade, although cardiac risks and contraindications must be checked. The pharmacist should query the prescription and avoid recommending dopamine-blocking antiemetics casually.

Reference: BNF; NICE CKS