Concept:
Chemotherapy-induced nausea and vomiting (CINV) is controlled by drugs acting on several receptor systems. Substance P, acting on neurokinin-1 (NK1) receptors, is a key mediator of the delayed phase of vomiting.
How it works: Aprepitant is a selective NK1 receptor antagonist. By blocking substance P at NK1 receptors in the vomiting centre, it prevents both acute and delayed CINV, and is usually combined with a 5-HT3 blocker and a corticosteroid.
Why the other choices are wrong: Ondansetron is a 5-HT3 antagonist. Dronabinol is a cannabinoid. Metoclopramide is mainly a dopamine D2 antagonist (with some 5-HT3 effect). None of these blocks NK1 receptors.
Answer: Option (2) — Aprepitant is the NK1 receptor antagonist. (2)