Which drug is administered to inhibit the release of Pancreatic Secretions in a patient with acute pancreatit… - RAK Nursing Officer - 2019

RAK Nursing Officer - 2019

Pharmacology

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Appeared in: RAK Nursing Officer - 2019

Explanation

Somatostatin is an inhibitory neuropeptide that suppresses the exocrine function of the pancreas, reducing the secretion of digestive enzymes and bicarbonate.
In acute pancreatitis, the pancreas is inflamed and autodigesting due to prematurely activated enzymes. Inhibiting these secretions helps to 'rest the pancreas', which is a key therapeutic goal.
Octreotide, a synthetic, long-acting analogue of somatostatin, is more commonly used in clinical practice for this purpose due to its longer half-life and potent inhibitory effects.

Option A: Pancreatin is a medication containing pancreatic enzymes. Administering it during acute pancreatitis would add to the enzyme load and worsen the autodigestion of the pancreas.
Option B: Acetylcholine is a primary neurotransmitter of the parasympathetic nervous system that stimulates pancreatic acinar cells to secrete digestive enzymes. This action is the opposite of what is needed in acute pancreatitis.
Option C: Nitroglycerine is a vasodilator used to treat angina and manage hypertension. It has no direct effect on inhibiting pancreatic exocrine secretions.

Clinical Relevance

Nursing practice connection: Use the key finding related to Pharmacological management of acute pancreatitis to guide bedside assessment, documentation, and the next nursing action.
The cornerstone of managing acute pancreatitis is reducing pancreatic stimulation. This is primarily achieved by keeping the patient NPO (nil per os) and providing aggressive intravenous fluid resuscitation.
When administering somatostatin or its analogue octreotide, the nurse must monitor the patient's blood glucose levels, as it can cause both hyperglycemia and hypoglycemia by inhibiting insulin and glucagon release.
Pain management is a critical nursing priority in acute pancreatitis, as the pain is typically severe and can lead to significant physiological stress.

How to Approach the Question

First, identify the key concept in the question: the need to inhibit pancreatic secretions in a patient with acute pancreatitis.
Analyze the pathophysiology: Acute pancreatitis involves inflammation and autodigestion caused by the pancreas's own enzymes. Therefore, the therapeutic goal is to reduce or stop enzyme secretion.
Evaluate each option based on its primary pharmacological action.
Eliminate Pancreatin because it contains pancreatic enzymes, which would worsen the condition.
Eliminate Acetylcholine because it is a known stimulator of digestive secretions.
Eliminate Nitroglycerine as its primary role is vasodilation for cardiac conditions, unrelated to pancreatic function.

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 2 p. 647-649

E6 Physiology Essentials Sembulingam 10e Part 2 p. 67-69