Anti-Metabolite

Question 1

Example

Answer 1

Methotrexate
5-Flurouracil
Gemtcitabine

Question 2

MoA

Answer 2

Prevent synthesis of purines or pyrimidines which are required for formation of DNA + RNA
(e.g. Methotrexate binds FH2 + inhibits dihydrofolate reductase in folic acid synthesis pathway;
5-Flurouracil inhibits thymidylate synthase (Rate-limiting step) preventing thymidine synthesis dUMP)

Question 3

Indications

Answer 3

1st Line DMARD (Methotrexate)
Colorectal, Breast, Pancreatic Cancer
Crohn’s disease (methotrexate)

Question 4

ADR

Answer 4

Blood disorders
Liver cirrhosis
Nephrotoxicity
GIT damage
NTD
Pulmonary fibrosis

Question 5

Prescribing Advice

Answer 5

X Pregnancy