skip to main content

Delayed levodopa dosing in hospital — SCE Geriatric Medicine MCQ

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

ModerateMovement disordersDelayed levodopa dosing in hospitalSCE Geriatric Medicine

An 87-year-old man with Parkinson disease and dementia is admitted after a fall. Medication administration records show co-careldopa is being given at 08:00, 12:00, 18:00 and 22:00, whereas at home he took it at 07:00, 10:30, 14:00, 17:30 and 21:00. He is now freezing before physiotherapy and has swallowed poorly at lunch. What is the most important next step?

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

Reveal the answer and explanation

Correct answer: A — Prescribe and administer levodopa at his individual home timings and review swallowing safety

Levodopa is time critical, and delayed or altered dosing can cause immobility, freezing, dysphagia and aspiration risk. Restoring the patient's usual regimen is often the quickest reversible intervention, alongside swallowing review and MDT input. Antipsychotics such as haloperidol can markedly worsen Parkinsonism. The pearl is that medicine timing is a functional intervention in Parkinson disease.

Reference: NICE NG71; Parkinson's UK time-critical medicines guidance