Review of Pharmacology - 9E (2015)

Review of Pharmacology
Chemotherapy C: Antineoplastic Drugs
54. Ans. (b) It does not cause hyperuricemia (Ref: KDT 6/e p823, 824)
• All anticancer drugs can result in hyperuricemia by causing the destruction of excess cells.
• Azathioprine is an immunosuppressant drug that acts by generating 6-MP.
• 6-MP is metabolized by xanthine oxidase. Its dose should be reduced when allopurinol is given concurrently.
55. Ans. (c) Adenosine deaminase (Ref: Katzung 10th/920)
• Pentostatin and cilastatin are not statins i.e. these do not act by inhibiting HMG-CoA reductase.
• Pentostatin acts by inhibiting adenosine deaminase.
• It is used for the treatment of hairy cell leukemia.
• Drug of choice for hairy cell leukemia is cladribine.
56. Ans. (a) 5-Fluorouracil (Ref: Katzung 11/e p947)
Capecitabine and 5-FU can cause hand and foot syndrome.
57. Ans. (c) Blindness (Ref: KDT 6/e p827, 828)
Cisplatin is the most emetic and nephrotoxic anticancer drug.
58. Ans. (a) G.I. toxicity (Ref: KDT 6/e p824; Harrison 16/e p596)
• Diarrhea is the most common adverse effect of 5-FU.
• It can also cause hand and foot syndrome and bone marrow suppression.
59. Ans. (b) Vomiting (Ref: KDT 6/e p827, 828)
Drug of choice for cisplatin induced vomiting is 5HT 3
antagonist like ondansetron.
60. Ans. (b) Cytarabine (Ref: Katzung 10th/888)
Cerebellar dysfunction is a prominent and distinctive adverse effect of cytarabine.
61. Ans. (b) Procarbazine (Ref: KDT 6/e p827)
62. Ans. (a) N-acetylcysteine (Ref: Harrison 18th/697)
N-acetylcysteine is used for paracetamol poisoning whereas slow intravenous infusion and chloride dieresis along with
amifostine can limit cisplatin induced nephrotoxicity.
63. Ans. (b) Mesna (Ref: Katzung 11/e p941)
The patient described in the question has hemorrhagic cystitis caused by drugs like cyclophosphamide and ifosfamide.
Hemorrhagic cystitis during therapy with cyclophosphamide or ifosfamide is caused by the urinary excretion of the toxic
metabolite acrolein. This can be prevented by aggressive hydration, bladder irrigation, and administration of mesna, a
sulfhydryl compound that binds acrolein in the urine.
64. Ans. (c) Dilated cardiomyopathy (Ref: Katzung 11/e p952)
• Anthracyclines (daunorubicin, doxorubicin, epirubicin and idarubicin)can cause severe cardiotoxicity manifesting
as dialted cardiomyopathy and arrhythmias.
• The anthracycline chemotherapeutic agents (doxorubicin, daunorubicin, epirubicin and idarubicin) form free
radicals in the myocardium. Their most severe side effect is a cumulative dose-related dilated cardiomyopathy.
It presents with symptoms of left and right ventricular CHF.
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65. Ans. (b) Nitrosourea (Ref: KDT 6/e p822)
Nitrosoureas like carmustine, lomustine and semustine can cross blood brain barrier and thus are used for treatment of
gliomas.
66. Ans. (a) Cisplatin (Ref: KDT 6/e p827, 828)
Cisplatin is most emetogenic and highly nephrotoxic anticancer drug.
67. Ans. (b) Methotrexate (Ref: KDT 6/e p823)
68. Ans. (c) GM-CSF (Ref: Katzung 10th/538)
Nitrogen mustards like mechlorethamine cause bone marrow suppression as major adverse effect. Leucopenia can be reversed
by sargramostim (recombinant GM-CSF). All nitrogen mustards do not cause hemorrhagic cystitis, therefore mesna
is not the answer.
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