Post-op Pharmacology Quiz

Question 1

Which of the following pathways is NOT a site for neurotransmitters involved in nausea and vomiting?

A) L type calcium channels
B) Serotonin type 3
C) Neurokinin 1
D) Dopamine 2

Answer 1

A - AV node is not a site for neurotransmitters involved in N/V

Question 2

Secondary risk factors for PONV include all EXCEPT:

A) Type of health insurance
B) Type of surgery - laparoscopic, gyn, ENT, neuro
C) Duration of surgery
D) Use of general anesthesia

Answer 2

A

Question 3

Match the antiemetic with the most accurate mechanism of action

Phenothiazines as well as butyrophenones, for example compazine, droperidol
5-HT3 receptor antagonists, for example ondansetron
Aprepitant
Scopolamine

Anticholinergic
Dopamine antagonist
Serotonin antagonist
NK 1 receptor antagonist

Answer 3

Phenothiazines as well as butyrophenones, for example compazine, droperidol - dopamine antagonist
5-HT3 receptor antagonists, for example ondansetron - serotonin antagonist
Aprepitant - NK 1 receptor antagonist
Scopolamine - anticholinergic

Question 4

Which of the following is NOT a primary risk factor PONV?

A) Female gender
B) Non-smoker
C) History of PONV and/or motion sickness
D) Riding a rental bicycle without wearing a helmet
E) Postoperative use of opioid analgesics

Answer 4

D

Question 5

A 55 year old woman with T1D of 40 years duration complains of severe bloating and abdominal distress, especially after meals. Evaluation is consistent with diabetic gastroparesis. Which of the following is a prokinetic drug that could be used in this situation?

A) Alosetron
B) Cimetidine
C) Loperamide
D) Metoclopramide

Answer 5

D - this is the same thing as reglan

Alosteron is a 5HT3 receptor blocker, cimetidine is a H2 receptor blocker, loperamide is an opioid

Only metoclopramide is considered a prokinetic agent (i.e. one that increases propulsive motility in the gut)