new_n_lost
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A 57-year-old man presents with a steady, severe pain in the right hypochondrium, nausea, vomiting, and a temperature of 102 F. He states that his signs and symptoms began shortly after eating his favorite pizza with extra cheese, pepperoni, and sausage. Laboratory examination reveals a white blood cell count of 13,400/mL and a serum bilirubin value of 2.8 mg/dL.
If hepatobiliary imaging reveals an obstructed cystic duct, which of the following agents would be the drug of choice for the treatment of this patient's pain?
A. Meperidine
B. Morphine
C. Naproxen
D. Oxycodone
E. Propoxyphene
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| tompat
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a.meperidine
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| drhouse
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A
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| po
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 dont give opiod since they cause biliary colic ,it will worsen pain.
I think its C.Naproxen
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| drhouse
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Hey PO
its morphine thats contraindicated in billiary colic, coz it causes contraction of bile duct.
while meperidine has M blocking property. and its good analgesic.
wot is yr opinion about neproxane
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everybody can do it.... its just matter of time
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| po
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ok,hav to go back to books.
thought all opiods r contrainicated in colicky pain
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| po
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whats ans? plzzz
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| mytime
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A
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| new_n_lost
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Tyrants and Occupiers of territories tend to think, act and feel alike "never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| new_n_lost
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The correct answer is A.
The patient is presenting with signs and symptoms of acute cholecystitis, which is associated with gallstones in more than 90% of all cases. This condition occurs when a stone becomes impacted in the cystic duct and inflammation develops behind the obstruction. The acute attack is often precipitated by a large fatty meal, and is characterized by the sudden appearance of severe, steady pain localized to the epigastrium or right hypochondrium. Laboratory findings often include elevated white blood cells (2,000 - 15,000/mL). Total serum bilirubin values of 1-4 mg/dL may be seen in some instances, and serum amylase may be elevated. In noncomplicated cases, treatment often includes IV alimentation, analgesics, and antibiotics, as well as withholding of oral feedings.
Meperidine is the narcotic of choice since it is least likely to cause spasm of the sphincter of Oddi, probably because of its antimuscarinic properties.
It is therefore preferred over morphine (choice B), oxycodone (choice D), and propoxyphene (choice E). Furthermore, propoxyphene is a narcotic agonist with mild analgesic properties; hence, it would most likely not be able to effectively treat this patient's severe pain.
Naproxen (choice C) is a nonsteroidal anti-inflammatory drug (NSAID) indicated for the treatment of mild to moderate pain; this agent would most likely not provide sufficient pain control for this patient.
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Tyrants and Occupiers of territories tend to think, act and feel alike "never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| Ig F
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a...mepiridine
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