GI drugs: antiemetics for chemotherapy: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · GI drugs: antiemetics for chemotherapy

Sample item

A woman receiving cisplatin for ovarian cancer has severe delayed vomiting despite ondansetron. Which agent should be added to target the delayed phase through a different receptor?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Aprepitant, an NK1 receptor antagonist

Delayed emesis after cisplatin is mediated substantially by substance P acting on NK1 receptors in the brainstem. Aprepitant, added to a 5-HT3 antagonist and dexamethasone, markedly improves control. Ondansetron also prolongs the QT interval, which is a safety consideration.

Option by option

  • A. Prochlorperazine

    Prochlorperazine is a weaker option for highly emetogenic chemotherapy.

  • B. Metoclopramide at low dose only

    Metoclopramide has modest benefit and is not first choice for delayed emesis.

  • C. Hyoscine

    Hyoscine is used for motion sickness, not chemotherapy emesis.

  • D. Aprepitant, an NK1 receptor antagonist (correct)

    Correct. NK1 blockade targets delayed emesis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Aprepitant, an NK1 receptor antagonist. Delayed emesis after cisplatin is mediated substantially by substance P acting on NK1 receptors in the brainstem.

Why is "Prochlorperazine" not the answer?

Prochlorperazine is a weaker option for highly emetogenic chemotherapy.

Why is "Metoclopramide at low dose only" not the answer?

Metoclopramide has modest benefit and is not first choice for delayed emesis.

Why is "Hyoscine" not the answer?

Hyoscine is used for motion sickness, not chemotherapy emesis.

What concept does this question test?

It tests GI drugs: antiemetics for chemotherapy in Pharmacology. Aprepitant, added to a 5-HT3 antagonist and dexamethasone, markedly improves control. Ondansetron also prolongs the QT interval, which is a safety consideration.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study GI drugs: antiemetics for chemotherapy?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.