Antiparkinsonian drugs: dopamine agonists: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Antiparkinsonian drugs: dopamine agonists

Sample item

A 55-year-old man with Parkinson's disease on pramipexole develops compulsive gambling and hypersexuality over three months. What is the most appropriate management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Gradually reduce or stop the dopamine agonist

Dopamine agonists, especially those acting on D3 receptors in the mesolimbic pathway, can cause impulse control disorders such as pathological gambling, hypersexuality and compulsive shopping. The agonist is tapered or stopped, with levodopa adjusted for motor control. Typical antipsychotics are avoided because they worsen parkinsonism.

Option by option

  • A. Add a monoamine oxidase inhibitor

    An MAO inhibitor raises dopamine and does not reverse the disorder.

  • B. Increase the pramipexole dose

    Raising the dose would intensify the behaviour.

  • C. Gradually reduce or stop the dopamine agonist (correct)

    Reducing the agonist addresses the cause of the impulse control disorder.

  • D. Start haloperidol

    Haloperidol blocks D2 receptors and would worsen parkinsonian motor symptoms.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, Gradually reduce or stop the dopamine agonist. Dopamine agonists, especially those acting on D3 receptors in the mesolimbic pathway, can cause impulse control disorders such as pathological gambling, hypersexuality and compulsive shopping.

Why is "Add a monoamine oxidase inhibitor" not the answer?

An MAO inhibitor raises dopamine and does not reverse the disorder.

Why is "Increase the pramipexole dose" not the answer?

Raising the dose would intensify the behaviour.

Why is "Start haloperidol" not the answer?

Haloperidol blocks D2 receptors and would worsen parkinsonian motor symptoms.

What concept does this question test?

It tests Antiparkinsonian drugs: dopamine agonists in Pharmacology. The agonist is tapered or stopped, with levodopa adjusted for motor control. Typical antipsychotics are avoided because they worsen parkinsonism.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antiparkinsonian drugs: dopamine agonists?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.