Prescribing Safety Assessment (PSA) Practice Exam

What is the anti-emetic of choice for prescribing in clinical practice?

1. Ondansetron 8mg

2. Cyclizine 50mg IV

3. Metoclopramide 10mg

4. Prochlorperazine 5mg

The correct answer is: Cyclizine 50mg IV

Cyclizine 50mg IV is considered the anti-emetic of choice in certain clinical scenarios, particularly for the management of nausea and vomiting associated with motion sickness, vertigo, or as part of the treatment regimen in palliative care. Cyclizine, which is an antihistamine with antiemetic properties, works by blocking histamine H1 receptors in the central nervous system, thereby reducing the vomiting reflex. The parenteral route of administration (IV) allows for rapid onset of action, which is particularly beneficial in acute settings where prompt relief of nausea is needed. In addition, cyclizine has a favorable safety profile and can be used effectively in a variety of patient populations, including those who may be unable to tolerate oral medications. Other options such as Ondansetron, Metoclopramide, and Prochlorperazine, while effective anti-emetics in their own rights, tend to be more situational in their best use. For example, Ondansetron is often favored for chemotherapy-induced nausea, Metoclopramide is more suited for gastrointestinal motility issues, and Prochlorperazine is good for psychogenic nausea but may have more side effects compared to cyclizine. Thus, the choice of anti-emetic