Finall Exam:l NU641/l NUl 641l (Latestl
2025/l 2026l Update)l Advancedl Clinicall
Pharmacologyl Guide|l Questionsl &l
Answers|l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l Regis
Q:l antiemetics
Answer:
symptoml reliefl forl n/v,l preventl fluidl andl electroyltel disturbancel
drugl classes
antihistamines:l diphenhydraminel (benadryl),l hydroxyzinel (vistaril)
phenothiazines:
prophorazinel (compazine),l promethazinel (phernagan)
cannibinoids:
dromabinoll (marinol)
5-HTl receptorl antagonists:
palonosteronl (aloxi),l ondandestronl etcl [-estron]
Q:l antihistaminesl asl antiemetics
Answer:
strongl anticholinergicl effectsl asl welll asl histamine1l blockingl effectsl =l antil SLUD=l lessl
salivation,l lacrimation,l urination,l defecation
ADR:l drowsiness,l dryl mouth,l blurredl visionl andl urinaryl retention
Q:l phenothiazines-antiemetics
Answer:
blockl dopaminel receptorsl inl thel chemoreceptorl triggerl zone,l alsol blocksl ACh,l alphal 1l
histaminel receptors
contraindicatedl inl Parkinsonsl **
,ADR:l drowsiness,l EPSl (dystonia,l akathisia,l TD)
-promethazine-l fatall respiratoryl depressionl inl kidsl youngerl thanl 2l yearsl ofl age,l
thereforel usuallyl notl usedl inl kids***
longl terml usel ofl promethazinel requiresl CBCl tol monitorl forl bonel marrowl depressionl
andl bloodl dyscrasiasl (weekl 4l andl 10l ofl therapy),l butl typicallyl usel shortl terml bcl
effectsl tol dopaminel receptors
Q:l Cannabinoidsl asl antiemetics
Answer:
workl inl thel CNSl tol preventl nauseal andl vomitingl assocaitedl withl cancerl chemotherapy
additivel CNSl depressionl withl CNSl depressants
dronabinol=l usel cautionl inl ptsl withl seizurel disorders,l withdrawll canl leadl tol seizures,l
canl causel behaviorl changesl
ADR:l euphoria,l depression,l dizziness,l parinoidl thoughts,l somnolence,l andl abnormall
thoughts
Cardiac:l palpitations,l tachycardia,l hypotension
seizurel andl seizurel likel activiity
Q:l antiemetics:l 5-HT3l receptorl antagonist
Answer:
ondanestron,l dolastron,l granestron
blockl serotoninl onl vagall nervel terminalsl andl inl thel chemol receptorl triggerl zone
usuallyl arel usedl overl shortl periodl ofl time
l
precaution;l mayl maskl progressivel ileus
ADR:l resultsl froml blockingl serotoninl froml binding,l b/cl freel serotoninl increse
-constipation,l headache,l fatigue,l dizziness,l diarrhea
-rarel casesl ofl tachycardia,l bradycardia,l hypotensionl andl QTl prolongationl (withl longl
terml use)
Q:l antiemeticsl clinicall use
Answer:
nauseal andl vomitingl duel tol drugsl orl gastritisl (oftenl aroundl chemol orl procedures)
-5-HTl recepetorl agoanists,l lowl s/el profilel [usuallyl firstl line]*****
,-phenothiazinesl (notl inl children):l typicallyl shortl term
-Dronabinoll isl onlyl forl usel inl CINVl andl appetitiel stimulation
-apreitant-l cinvl andl ponv
motionl sickness
-antihistamines=l dimenhydrinatel (dramamine)l andl mexlizinel (antivert)
-takel 1l tol 2l hoursl beforel departurel tol treatl motionl sickness
vomitingl duel tol gastroparesis
-prokineticl drugsl (meoploramide-l reglan)
scopalamine-anticholerigcl patch=l goodl forl motionl sickness,l pre-opl prevention
-cautionl withl elderly,l contraindicatedl inl bladderl neckl obstructionl andl glaucoma
Q:l histaminel 2l receptorl antagonistsl (H2l RAs)
Answer:
inhibitl acidl secretionl byl gastricl parietall cellsl throughl al reversiblel blockadel ofl histaminel
atl histaminel 2l (canl impactl H1)
uses
-reducel gastricl acidl inl patientsl whol arel temporarilyl notl takingl anythingl byl mouth
-prophylasizl andl managmentl ofl duodenall andl gastricl ulcersl (stepl downl afterl PPIl orl inl
combination)
-GERD
-heartburn,l acidl indigestion
famotidinel (pepcid),l cimetidinel (tagament-l lotsl ofl interactionsl notl givenl al lot)
Q:l H2l RAl PDl andl precautions
Answer:
PD:l reversiblel competitivel blockersl ofl histaminel atl histaminel receptors,l highlyl selective,l
reducesl gastricl acidl secretionl byl 35-50%
precautions:
-cautiousl usel inl renall impairment
-hepatocellularl injuryl withl nizatidine
-pregl B
-Famotidinel approvedl inl infantsl andl kids
Q:l H2RAl ADR
, Answer:
antiandrogenicl reactions=l gynecomastia,l impotencel (cimetidinel thel worst)
CNSl adversel reactionsl (samitodenel worst)=l mentall confusion,l agitiation,l psychosis,l
depressionl andl disorientation
hemal effects:l agranculocytosis,l granuloctopenia,l thrombocytopenia,l andl aplasticl anemia.l
(alll rare)l
avoidl alc**,l monitorl liverl functionl withl highl dosel orl longl terml use
Q:l H2RAl clinicall use
Answer:
GERD
-BID,l nol longerl recommendedl forl empiricl treatmentl ofl infantsl withl GERD
PUD
-notl usedl asl primaryl treatmentl (secondaryl tol PPI),l usedl asl stepl downl therapy
heartl burn,l acidl indigestion:l OTCl dosing
decreasel dosel forl renall dysfunction
Q:l H2l RAl patientl education
Answer:
admin:l takel withl meals,l seperatel antacidsl byl 30l minl tol 1l hr
adversel reactions:
-mayl causel drowsinessl orl dizziness,l cimetidine=l gynecomastial andl impotence
nol alcl (gutl irriation)l orl smokingl (decreasesl absorptionl ofl med)
Q:l prokinetics
Answer:
stimulatel thel motilityl ofl thel GIl tractl withoutl stimulatingl gastric,l biliaryl orl pancreaticl
secretions
metoclopramidel (reglan)l isl onlyl drugl inl thisl class
PD;l stimulatesl motilityl inl thel upperl GIl tract,l similarl actionl tol phenothiazines,l andl
dopaminel antagonistsl butl usedl cautiouslyl bcl BBW
2025/l 2026l Update)l Advancedl Clinicall
Pharmacologyl Guide|l Questionsl &l
Answers|l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l Regis
Q:l antiemetics
Answer:
symptoml reliefl forl n/v,l preventl fluidl andl electroyltel disturbancel
drugl classes
antihistamines:l diphenhydraminel (benadryl),l hydroxyzinel (vistaril)
phenothiazines:
prophorazinel (compazine),l promethazinel (phernagan)
cannibinoids:
dromabinoll (marinol)
5-HTl receptorl antagonists:
palonosteronl (aloxi),l ondandestronl etcl [-estron]
Q:l antihistaminesl asl antiemetics
Answer:
strongl anticholinergicl effectsl asl welll asl histamine1l blockingl effectsl =l antil SLUD=l lessl
salivation,l lacrimation,l urination,l defecation
ADR:l drowsiness,l dryl mouth,l blurredl visionl andl urinaryl retention
Q:l phenothiazines-antiemetics
Answer:
blockl dopaminel receptorsl inl thel chemoreceptorl triggerl zone,l alsol blocksl ACh,l alphal 1l
histaminel receptors
contraindicatedl inl Parkinsonsl **
,ADR:l drowsiness,l EPSl (dystonia,l akathisia,l TD)
-promethazine-l fatall respiratoryl depressionl inl kidsl youngerl thanl 2l yearsl ofl age,l
thereforel usuallyl notl usedl inl kids***
longl terml usel ofl promethazinel requiresl CBCl tol monitorl forl bonel marrowl depressionl
andl bloodl dyscrasiasl (weekl 4l andl 10l ofl therapy),l butl typicallyl usel shortl terml bcl
effectsl tol dopaminel receptors
Q:l Cannabinoidsl asl antiemetics
Answer:
workl inl thel CNSl tol preventl nauseal andl vomitingl assocaitedl withl cancerl chemotherapy
additivel CNSl depressionl withl CNSl depressants
dronabinol=l usel cautionl inl ptsl withl seizurel disorders,l withdrawll canl leadl tol seizures,l
canl causel behaviorl changesl
ADR:l euphoria,l depression,l dizziness,l parinoidl thoughts,l somnolence,l andl abnormall
thoughts
Cardiac:l palpitations,l tachycardia,l hypotension
seizurel andl seizurel likel activiity
Q:l antiemetics:l 5-HT3l receptorl antagonist
Answer:
ondanestron,l dolastron,l granestron
blockl serotoninl onl vagall nervel terminalsl andl inl thel chemol receptorl triggerl zone
usuallyl arel usedl overl shortl periodl ofl time
l
precaution;l mayl maskl progressivel ileus
ADR:l resultsl froml blockingl serotoninl froml binding,l b/cl freel serotoninl increse
-constipation,l headache,l fatigue,l dizziness,l diarrhea
-rarel casesl ofl tachycardia,l bradycardia,l hypotensionl andl QTl prolongationl (withl longl
terml use)
Q:l antiemeticsl clinicall use
Answer:
nauseal andl vomitingl duel tol drugsl orl gastritisl (oftenl aroundl chemol orl procedures)
-5-HTl recepetorl agoanists,l lowl s/el profilel [usuallyl firstl line]*****
,-phenothiazinesl (notl inl children):l typicallyl shortl term
-Dronabinoll isl onlyl forl usel inl CINVl andl appetitiel stimulation
-apreitant-l cinvl andl ponv
motionl sickness
-antihistamines=l dimenhydrinatel (dramamine)l andl mexlizinel (antivert)
-takel 1l tol 2l hoursl beforel departurel tol treatl motionl sickness
vomitingl duel tol gastroparesis
-prokineticl drugsl (meoploramide-l reglan)
scopalamine-anticholerigcl patch=l goodl forl motionl sickness,l pre-opl prevention
-cautionl withl elderly,l contraindicatedl inl bladderl neckl obstructionl andl glaucoma
Q:l histaminel 2l receptorl antagonistsl (H2l RAs)
Answer:
inhibitl acidl secretionl byl gastricl parietall cellsl throughl al reversiblel blockadel ofl histaminel
atl histaminel 2l (canl impactl H1)
uses
-reducel gastricl acidl inl patientsl whol arel temporarilyl notl takingl anythingl byl mouth
-prophylasizl andl managmentl ofl duodenall andl gastricl ulcersl (stepl downl afterl PPIl orl inl
combination)
-GERD
-heartburn,l acidl indigestion
famotidinel (pepcid),l cimetidinel (tagament-l lotsl ofl interactionsl notl givenl al lot)
Q:l H2l RAl PDl andl precautions
Answer:
PD:l reversiblel competitivel blockersl ofl histaminel atl histaminel receptors,l highlyl selective,l
reducesl gastricl acidl secretionl byl 35-50%
precautions:
-cautiousl usel inl renall impairment
-hepatocellularl injuryl withl nizatidine
-pregl B
-Famotidinel approvedl inl infantsl andl kids
Q:l H2RAl ADR
, Answer:
antiandrogenicl reactions=l gynecomastia,l impotencel (cimetidinel thel worst)
CNSl adversel reactionsl (samitodenel worst)=l mentall confusion,l agitiation,l psychosis,l
depressionl andl disorientation
hemal effects:l agranculocytosis,l granuloctopenia,l thrombocytopenia,l andl aplasticl anemia.l
(alll rare)l
avoidl alc**,l monitorl liverl functionl withl highl dosel orl longl terml use
Q:l H2RAl clinicall use
Answer:
GERD
-BID,l nol longerl recommendedl forl empiricl treatmentl ofl infantsl withl GERD
PUD
-notl usedl asl primaryl treatmentl (secondaryl tol PPI),l usedl asl stepl downl therapy
heartl burn,l acidl indigestion:l OTCl dosing
decreasel dosel forl renall dysfunction
Q:l H2l RAl patientl education
Answer:
admin:l takel withl meals,l seperatel antacidsl byl 30l minl tol 1l hr
adversel reactions:
-mayl causel drowsinessl orl dizziness,l cimetidine=l gynecomastial andl impotence
nol alcl (gutl irriation)l orl smokingl (decreasesl absorptionl ofl med)
Q:l prokinetics
Answer:
stimulatel thel motilityl ofl thel GIl tractl withoutl stimulatingl gastric,l biliaryl orl pancreaticl
secretions
metoclopramidel (reglan)l isl onlyl drugl inl thisl class
PD;l stimulatesl motilityl inl thel upperl GIl tract,l similarl actionl tol phenothiazines,l andl
dopaminel antagonistsl butl usedl cautiouslyl bcl BBW
