71 year, history of weight loss over the past few weeks

[Oak]

A 71 yr old male is noted as having a 9 pound weight loss over the past few weeks. His past medical history is significant for oat cell carcinoma of the lung, without known metastases, for which he is currently undergoing treatment. The patient states that even though his wife is preparing his favorite meals, he is not hungry. Which of the following would be the best treatment option to improve his eating habits?

A. Amitriptyline
B. Megestrol acetate
C. Methotrexate
D. Neostigmine
E. Prochlorperazine

[Hero]

I go for (B) Megestrol acetate. This is the drug which is commonly used to increase appetite in patients on chemotherapy.

[bharat]

Originally Posted by Oak

A 71 yr old male is noted as having a 9 pound weight loss over the past few weeks. His past medical history is significant for oat cell carcinoma of the lung, without known metastases, for which he is currently undergoing treatment. The patient states that even though his wife is preparing his favorite meals, he is not hungry. Which of the following would be the best treatment option to improve his eating habits?

A. Amitriptyline
B. Megestrol acetate
C. Methotrexate
D. Neostigmine
E. Prochlorperazine

well i think hero is correct answer should be B becasue
Megestoral Acetate is a synthetic progestin with progestational effects similar to those of progesterone;
current uses include palliation in breast cancer and as an appetite stimulant in advanced malignancy.
waiting for your reply bro.

[Oak]

Yh both of you are right, the correct answer is B. One of the most common side effects of any antineoplastic therapy is weight loss secondary to decreased appetite and/or nausea and vomiting. Furthermore, weight loss due to decreased food intake tends to occur more frequently in elderly patients receiving antineoplastic therapy. One medication that has consistently helped to increase appetite in such patients is megestrol acetate. This agent is a progestational hormone with antineoplastic properties used in the treatment of advanced carcinoma of the breast and endometrium. Megestrol, when given in relatively high doses, can substantially increase the appetite in most individuals, even those with advanced cancer.

Amitriptyline (choice A) is a tricyclic antidepressant used in the treatment of depression. There is nothing mentioned in the case study to suggest that the patient is clinically depressed; hence, this agent would provide no benefit.

Methotrexate (choice C) is an antimetabolite and folic acid antagonist commonly used in various neoplastic disorders and in the treatment of rheumatoid arthritis. Since nausea, vomiting, and ulcerative stomatitis are common side effects of this medication, its usage in this patient would not be recommended.

Neostigmine (choice D) is a carbamylating acetylcholinesterase inhibitor that would not increase appetite.

Prochlorperazine (choice E) is a phenothiazine derivative used primarily to control severe nausea and vomiting. This patient is not experiencing nausea. Furthermore, this agent does not possess appetite-stimulating properties.