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Prokinetic antiemetic — FRCA Primary MCQ

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ModeratePharmacologyProkinetic antiemeticFRCA Primary

An emergency surgical patient with gastroparesis needs an antiemetic that promotes gastric emptying. Which drug is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Metoclopramide

Metoclopramide has prokinetic and antiemetic effects through dopamine antagonism. Atropine is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Four-factor prothrombin complex concentrate with vitamin K is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Idarucizumab is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Ketamine is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. In Primary FRCA pharmacology, link the clinical effect to the receptor, distribution or elimination mechanism rather than memorising isolated facts.

Reference: Peck, Hill & Williams Pharmacology for Anaesthesia and Intensive Care; BNF; Primary FRCA textbooks