Which medicine is most suitable to continue on the day of surgery?

• A. Ibuprofen
• B. Co-careldopa
• C. Amlodipine
• D. Simvastatin

Answer: (B)

Maintaining regular chronic therapy on the day of surgery to prevent withdrawal and deterioration of the underlying condition is essential. For Parkinson’s disease, this means continuing dopaminergic treatment because abrupt cessation can cause severe motor worsenings, such as rigidity, akinesia, and complications with airway protection and ventilation.

Co-careldopa (carbidopa-levodopa) is the medicine that should be continued because it directly restores brain dopamine levels and smoothes motor function. Stopping it can lead to rapid deterioration in motor control and complicate the perioperative course. The combination also helps minimize peripheral side effects and nausea, and it can be given with a small amount of water if the patient is not eating, keeping the dosing on schedule as much as possible.

Ibuprofen carries a higher risk of perioperative bleeding and wound healing issues, so it is often avoided around surgery. The other medications listed—amlodipine and simvastatin—are typically continued, but the question focuses on which drug's continuation is most critical to maintain stability during surgery, which is the dopaminergic therapy.