CNS drugs and antiepileptics: Parkinson disease off episodes: 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 · CNS drugs and antiepileptics: Parkinson disease off episodes

Sample item

A man with Parkinson disease on levodopa-carbidopa has sudden unpredictable freezing 'off' episodes that do not respond quickly to oral doses. Which subcutaneously injected dopamine agonist is used for rapid rescue?

APramipexoleBRopiniroleCBromocriptineDApomorphine

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

The answer and the reasoning

D. Apomorphine

Apomorphine is a potent dopamine agonist given by subcutaneous injection or infusion, with onset in minutes, so it rescues sudden off periods. It causes severe nausea, so an antiemetic such as domperidone is given first. Bromocriptine, pramipexole and ropinirole are oral agonists.

Option by option

A. Pramipexole
Pramipexole is an oral non-ergot agonist and cannot give rapid rescue.
B. Ropinirole
Ropinirole is an oral non-ergot agonist and is not given as a rescue injection.
C. Bromocriptine
Bromocriptine is an oral ergot agonist with slow onset.
D. Apomorphine (correct)
Correct. It acts within minutes by injection and is used as rescue for off periods.

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.

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Apomorphine. Apomorphine is a potent dopamine agonist given by subcutaneous injection or infusion, with onset in minutes, so it rescues sudden off periods.

Why is "Pramipexole" not the answer?

Pramipexole is an oral non-ergot agonist and cannot give rapid rescue.

Why is "Ropinirole" not the answer?

Ropinirole is an oral non-ergot agonist and is not given as a rescue injection.

Why is "Bromocriptine" not the answer?

Bromocriptine is an oral ergot agonist with slow onset.

What concept does this question test?

It tests CNS drugs and antiepileptics: Parkinson disease off episodes in Pharmacology. It causes severe nausea, so an antiemetic such as domperidone is given first. Bromocriptine, pramipexole and ropinirole are oral agonists.

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 CNS drugs and antiepileptics: Parkinson disease off episodes?

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.