Drug of choice for late cisplatin induced vomiting is
**Core Concept**
The question tests the student's knowledge of **antiemetic therapy**, specifically in the context of **chemotherapy-induced nausea and vomiting**. Cisplatin is a **chemotherapeutic agent** known to cause severe vomiting, and the management of this side effect is crucial for patient comfort and compliance with treatment.
**Why the Correct Answer is Right**
Although the correct answer is not specified, **metoclopramide** and **ondansetron** are commonly used for cisplatin-induced vomiting. However, for **late-phase vomiting**, which occurs more than 24 hours after chemotherapy, **NK1 receptor antagonists** like **aprepitant** are often used in combination with other antiemetics. The exact mechanism involves blocking the **substance P/neurokinin 1 (NK1) receptor**, which plays a key role in the vomiting reflex.
**Why Each Wrong Option is Incorrect**
**Option A:** Without the specific option provided, it's challenging to give a precise reason, but if it's not an **NK1 receptor antagonist** or a combination that includes one, it's likely incorrect for late-phase vomiting.
**Option B:** Similarly, without the option, if it doesn't involve a mechanism to address late-phase vomiting, it would be incorrect.
**Option C:** If this option is a drug that only addresses acute vomiting, it would not be the best choice for late cisplatin-induced vomiting.
**Option D:** Assuming this is not the correct class of drug for late-phase vomiting, it would be an incorrect choice.
**Clinical Pearl / High-Yield Fact**
Remember, the management of chemotherapy-induced nausea and vomiting involves different strategies for acute (within 24 hours) and delayed (beyond 24 hours) phases. **NK1 receptor antagonists** are particularly useful for preventing delayed emesis.
**Correct Answer:** Correct Answer: D. Aprepitant