Prescribing Safety Assessment (PSA) Practice Exam

In which condition should metoclopramide be avoided?

1. Diabetes

2. Parkinson's disease

3. Heart failure

4. Chronic migraines

The correct answer is: Parkinson's disease

Metoclopramide is a medication primarily used to treat nausea and gastroparesis, but it has significant implications in certain neurological conditions. In the case of Parkinson's disease, metoclopramide can be avoided because it has dopaminergic antagonistic effects on the central nervous system. This means that it can block dopamine receptors, which is particularly problematic in individuals with Parkinson's disease, as the condition is characterized by a deficiency of dopamine. Administering metoclopramide in this scenario could exacerbate the symptoms of Parkinson's, such as bradykinesia and rigidity, and may lead to worsening of the patient's condition or the emergence of drug-induced parkinsonism. While there may be concerns regarding the use of metoclopramide in other conditions like diabetes, heart failure, or chronic migraines, its primary contraindication arises from its interaction with the dopamine pathways in patients with Parkinson's disease. This highlights the critical importance of understanding the pharmacodynamics of medications and their potential neurological side effects in vulnerable populations.