6172 Exam (Lippincott) Study Questions
and Answers.
40.1 A 68-year-old patient with cardiac failure is diagnosed with 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 - Answer 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.
40.2 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 - Answer 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.
40.3 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 - Answer Correct answer = B.
and Answers.
40.1 A 68-year-old patient with cardiac failure is diagnosed with 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 - Answer 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.
40.2 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 - Answer 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.
40.3 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 - Answer Correct answer = B.
