clinical cases

Question 1

if patient has dry cough and decreased resiudal volume and dyspenia which drug he used? that also can induces free radicals formation that lead to breaks in DNA strand ?

Answer 1

bleomycin

because these symptoms is related to pulmonary fibrosis

Question 2

after patient took antitumor drug he had dark skin. which drug was used?

Answer 2

bleomycin

it induces cytokines which activate melaonocytes (hyperpigmentation)

Question 3

what is the clinical use of bleomycin

Answer 3

testicular cancer and hodgkin lymphoma

Question 4

which drug can cause easy brusing bleeding ,weaknes,recurrent infection,anemia and intercalate into DNA preventing RNA synthesis?

Answer 4

dactinomycin(actinomycin D)

symptoms of mylosuppression

Question 5

what is the clinical use of dactinomycin(actinomycin D)

Answer 5

Wilms tumor, Ewing sarcoma,
rhabdomyosarcoma

Question 6

patient used one drug after that he felt tachycardia,dyspenia,and he got edema in lung. which drug did he use? and how can we prevent these adverse effects ?

Answer 6

Anthracyclines
(Doxorubicin,daunorubicin)
for preventian: dexrazoxane

cardiomyopathy

Question 7

which drug Generate free radicals
Intercalate in DNA →breaks in
DNA →↓ replication
and
Inhibit topoisomerase II

Answer 7

Anthracyclines
Doxorubicin,
daunorubicin

Question 8

clinical use of Anthracyclines
(Doxorubicin, daunorubicin)

Answer 8

Solid tumors, leukemias,
lymphomas

Question 9

150-years old man has gaut disease and he takes allopurinol and febuxostat, last week he suffered from acute lymphoplastic anemia, a doctor discribed a drug for him but after he took it he got Yellowing of the skin and whites of the eyes,Itching and Abdominal pain in the upper right portion of the abdomen.which drug you think he took ?

Answer 9

thiopurines (6-MP, azathioprine)

these symptomes mean that he got liver toxicity after taking the drug

Question 10

what is the prodrug for Thiopurines (Azathioprine,
6-mercaptopurine) ?

Answer 10

HGPRT

Hypoxanthine-guanine phosphoribosyltransferase

Question 11

which drug can cause easy brusing bleeding ,weaknes,recurrent infection,anemia →↓ de novo purine synthesis AZA is converted to 6-MP?

Answer 11

Thiopurines
(Azathioprine, 6mercaptopurine)

Question 12

which drug can cause easy brusing bleeding ,weaknes,recurrent infection,anemia. it is a Purine analogs→ multiple mechanisms (eg, inhibition of
ADA, DNA strand breaks)

Answer 12

Cladribine, pentostatin

Myelosuppression

Question 13

what is the clinical use for (Cladribine, pentostatin) ?

Answer 13

Hairy cell leukemia

Question 14

which drug can cause easy brusing bleeding ,weaknes,recurrent infection,anemia and we can use it to treat
Leukemias (AML), lymphomas it is Pyrimidine analog → DNA chain termination
Inhibits DNA polymerase ?

Answer 14

Cytarabine
(arabinofuranosyl cytidine)

Question 15

patient has Colon cancer was described a drug after he took the drug he got a Thick calluses and blisters on the palms of his hands and soles of his feet. what is the mechanisim of this drug ?

Answer 15

Pyrimidine analog bioactivated
to 5-FdUMP→ thymidylate
synthase inhibition
→↓ dTMP →↓ DNA synthesis

5-Fluorouracil

Question 16

patient used a drug for actinic keratosis then he got treated but after a period of time this drug was useless due to decreasing the prodrug activation of this medicine? which prodrug is inactivated here?

Answer 16

Capecitabine

Question 17

patient was described a medicine then he got Abnormal paleness (lack of color of the skin) ,Decreased appetite,Irritability.
under microscope we found that he has a abnormally large blood cells. which drug he used and what is the mechanism of this drud ?

Answer 17

Hydroxyurea
Inhibits ribonucleotide
reductase →↓ DNA synthesis

Question 18

patient has incresed red blood cells production and other pateint has red blood cells cresent like shape which drug can be used which Inhibits ribonucleotide
reductase →↓ DNA synthesis

Answer 18

Hydroxyurea

Question 19

which drug can cause easy brusing bleeding ,weaknes,recurrent infection,anemia and inhibits
dihydrofolate reductase leading to inhibit DNA synthesis

Answer 19

Methotrexate

Question 20

we can not give a pregnant women this drug because it can cause spina bifida in the fetus

Answer 20

Methotrexate

Question 21

if pateint has rhumatiod arthiritis and nephrotoxicity and does not respond to steriod we should give him ?

Answer 21

thiopurines
(azathiopurine,6mercaptopurin)

Question 22

if patient has dry cough and decreased resiudal volume and dyspenia and dark skin which antitumor antibiotic he used?

Answer 22

bleomycin

Question 23

if patient has dry cough and decreased resiudal volume and dyspenia and dark skin which alkylating drug he used?

Answer 23

busulfan