Alkylating Agents

Question 1

Mechlorethamine (1)

Answer 1

Alkylating agent; spontaneous conversion to active metabolites in body fluids or enzymatically converted in liver

Question 2

Cyclophosphamide (Cytoxan) (1)

Answer 2

Alkylating agent; conversion by hepatic cytochrome P450 to active metabolite phosphoramide mustard

Question 3

Ifosfamide (1)

Answer 3

Alkylating agent; conversion by hepatic cytochrome P450 to active metabolite phosphoramide mustard

Question 4

Mechlorethamine (2)

Answer 4

Hodgkin’s disease, topically for treatment of cutaneous T-cell lymphoma

Question 5

Cyclophosphamide (Cytoxan) (2)

Answer 5

Most widely used alkylating agent (broad clinical spectrum); singly or in combination for ALL, CLL, non-Hodgkin’s lymphoma, and breast, lung, and ovarian cancer

Question 6

Ifosfamide (2)

Answer 6

Sarcoma and testicular cancer

Question 7

Mechlorethamine (3)

Answer 7

Severe nausea and vomiting, myelosuppression (leucopenia, thrombocytopenia)

Question 8

Cyclophosphamide (Cytoxan) (3)

Answer 8

Hemorrhagic cystitis (bladder irritation) due to acrolein (toxic drug metabolite); adequate hydration and administration of MESNA (2-mercaptoethane sulfonate) minimizes problem. Nausea, vomiting, myelosuppression

Question 9

Ifosfamide (3)

Answer 9

Hemorrhagic cystitis (bladder irritation) due to acrolein (toxic drug metabolite); adequate hydration and administration of MESNA (2-mercaptoethane sulfonate) minimizes problem. Nausea, vomiting, myelosuppression

Question 10

Carmustine (1)

Answer 10

Alkylating agent

Question 11

Lomustine (1)

Answer 11

Alkylating agent

Question 12

Carmustine (2)

Answer 12

Brain tumors (cross blood-brain barrier)

Question 13

Lomustine (2)

Answer 13

Brain tumors (cross blood-brain barrier)

Question 14

Carmustine (3)

Answer 14

Renal toxicity, pulmonary fibrosis. Profound myelosuppression, severe nausea and vomiting

Question 15

Lomustine (3)

Answer 15

Renal toxicity, pulmonary fibrosis. Profound myelosuppression, severe nausea and vomiting

Question 16

Decarbazine (1)

Answer 16

Alkylating agent; prodrug activated by liver cytochromes

Question 17

Temozolomide (1)

Answer 17

Alkylating agent; nonenzymatic conversion to methylhydrazine at physiologic pH

Question 18

Decarbazine (2)

Answer 18

Part of ABVD for Hodgkin’s disease; also, malignant melanoma. IV ADMIN

Question 19

Temozolomide (2)

Answer 19

Malignant gliomas ORAL ADMIN

Question 20

Decarbazine (3)

Answer 20

Nausea and vomiting, myelosuppression (neutropenia, thrombocytopenia), flu-like symptoms (fever, fatigue)

Question 21

Temozolomide (3)

Answer 21

Nausea and vomiting, myelosuppression (neutropenia, thrombocytopenia), flu-like symptoms (fever, fatigue)

Question 22

Cisplatin (1)

Answer 22

covalently bind nucleophilic sites on DNA (e.g., guanine N7); converted to active cytotoxic forms by reacting with water to form (+)charged, hydrated intermediates that react with DNA guanine, forming inter- and intrastand cross-links

Question 23

Carboplatin (1)

Answer 23

covalently bind nucleophilic sites on DNA (e.g., guanine N7); converted to active cytotoxic forms by reacting with water to form (+)charged, hydrated intermediates that react with DNA guanine, forming inter- and intrastand cross-links

Question 24

Oxaliplatin (1)

Answer 24

covalently bind nucleophilic sites on DNA (e.g., guanine N7); converted to active cytotoxic forms by reacting with water to form (+)charged, hydrated intermediates that react with DNA guanine, forming inter- and intrastand cross-links

Question 25

Cisplatin (2)

Answer 25

Testicular, ovarian, cervical, and bladder cancers; also useful in treatment of head and neck cancer, and lung carcinoma

Question 26

Carboplatin (2)

Answer 26

Ovarian cancer

Question 27

Oxaliplatin (2)

Answer 27

Gastric and colorectal cancer

Question 28

Cisplatin (3)

Answer 28

Nephrotoxicity, ototoxicity, peripheral motor and sensory neuropathy at high doses. Myelosupression. Severe nausea and vomiting

Question 29

Carboplatin (3)

Answer 29

Myelosuppression (thrombocytopenia)

Question 30

Oxaliplatin (3)

Answer 30

Peripheral sensory neuropathy (cold-induced). Neutropenia