Medical Pharmacology Clinical Case: Gastrointestinal Drug Pharmacology

Medical Pharmacology: Gastrointestinal Clinical Case

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A 28 year-old woman at full-term pregnancy became a candidate for cesarean section because of dystocia cause by fetal malposition.
According to clinical standards, she was about 50 pounds overweight.
General anesthesia was chosen for the surgical procedure.

Definition: Dystocia: difficult labor caused by the contraction of an area of circular muscle fibers, which may occur in various levels of the parturient uterus.
Case author: Hugh S. Mathewson, M.D., Professor Emeritus, School of Allied Health, Department of Nurse Anesthesia, University of Kansas Medical Center
case editor: Michael Gordon, Ph.D.

What is the principal risk encountered in this patient on anesthetic induction?
1. aspiration of gastric contents
2. paroxysmal hypertension
3. bronchospasm
4. abnormal uterine contraction
What would be the best drug to be given as preanesthetic medication to promote gastric emptying?
1. atropine
2. ipratropium (Atrovent)
3. metoclopramide (Reglan)
4. glycopyrrolate (Robinul)
Is there a contraindication to the use of metoclopramide?
1. pregnancy
2. renal disease
3. pancreatic insufficiency
4. Parkinsonism

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