Lippincott® Illustrated Reviews- GIT
Pharmacology. Questions And Answers
2023 Update A+
A 68-year-old patient with cardiac failure is diagnosed with
... [Show More] ovarian cancer. She begins
using cisplatin but becomes nauseous and suffers from severe vomiting. Which drug
would be most effective to counteract the emesis in this patient without exacerbating her
cardiac problem?
A. Droperidol
B. Dolasetron
C. Prochlorperazine
D. Palonosetron - Correct answer = D. Palonosetron is a 5-HT3 antagonist that is
effective against drugs with high emetogenic activity, such as cisplatin. Although
dolasetron is also in this category, its propensity to affect the heart makes it a poor
choice for this patient. Droperidol is only a moderately effective antiemetic and has the
potential to prolong the QTc interval, so it is not preferred in this patient. The antiemetic
effect of prochlorperazine, a phenothiazine, is most beneficial against anticancer drugs
with moderate to low emetogenic properties
A 45-year-old woman complains of severe persistent heartburn and an unpleasant,
acid-like taste in her mouth. The clinician suspects that she has gastroesophageal reflux
disease. Which drug is most appropriate?
A. An antacid such as aluminum hydroxide
B. Dicyclomine
C. Granisetron
D. Esomeprazole - Correct answer = D. It is appropriate to treat this patient with a
proton-pump inhibitor (PPI) to reduce acid production and promote healing. An H2
receptor antagonist might also be effective, but the PPIs are preferred. An antacid
would decrease gastric acid, but its effects are short lived compared to those of the
PPIs and H2 receptor antagonists. Dicyclomine is an antimuscarinic drug that is mainly
used as an antispasmodic for IBS. The 5-HT3 receptor antagonist granisetron is an
antiemetic, and not appropriate for the treatment of GERD
A couple celebrating their 30th wedding anniversary are given a trip to Peru to visit
Machu Picchu. Because of past experiences while traveling, they ask their doctor to
prescribe an agent in case they experience diarrhea. Which drug would be effective?
A. Omeprazole
B. Loperamide
C. Famotidine
D. Lubiprostone - Correct answer = B. Loperamide is the only drug that has
antidiarrheal activity. Omeprazole is a proton-pump inhibitor, famotidine antagonizes the
H2 receptor to reduce acid production, and lubiprostone is indicated for chronic
constipation or IBS-C.
A 27-year-old woman who is 34 weeks' pregnant is on bed rest and is experiencing mild
constipation. Which drug is most appropriate for her?... [Show Less]