cytotoxic

Question 1

Cyclophosphamide
Chlorambucil

•alkylating Nitrogen mustard derivative and is cell-cycle

Answer 1

nonspecific, producing DNA cross-linkages at any point in the cell cycle

Question 2

Cyclophosphamide ADR

Answer 2

lymphoma, leukemia, bladder carcinoma, and squamous cell

carcinoma, and leukopenia from bone marrow suppression

Question 3

Cyclophosphamide Hemorrhagic cystitis is associated with the increased risk of transitional cell carcinoma of the bladder and can occur in up to

Answer 3

40% of treated patients

Question 4

if red blood cells are detected in the urine

Answer 4

cyclophosphamide must be discontinued

Question 5

Cyclophosphamide Bladder toxicity

used to reduce this toxic effect

Answer 5

acrolein metabolite

mesna (sodium 2 mercaptoethanesulfonate)

Question 6

Chlorambucil notable adverse effects

• Steroid-sparing agent in the treatment of vasculitis, Behcet’s disease, dermatomyositis,
histiocytosis X, and sarcoidosis

Answer 6

• Bone marrow suppression with leukopenia, oral ulcers, amenorrhea and azoospermia

Question 7

Chlorambucil

In children with nephritic syndrome or adults with a seizure history, can cause

Answer 7

generalized

tonic-clonic seizures

Question 8

S-phase specific antimetabolite

Answer 8

Methotrexate, hydroxyurea

Question 9

Methotrexate competitively and irreversibly blocks dihydrofolate reductase from catalyzing the formation of

Answer 9

tetrahydrofolate, an important cofactor in

thymidylate and purine synthesis

Question 10

Cumulative doses at or above?

can risk inducing liver fibrosis and cirrhosis;

Answer 10

4.0 grams

Question 11

methotrexate use Uncommonly causes

Answer 11

acute pneumonitis and pulmonary fibrosis

Question 12

Trimethoprim, the sulfonamides, and dapsone, which inhibit the folic acid metabolic pathway, when combined with methotrexate

Answer 12

can lead to hematologic toxicity

Question 13

which drugs increase methotrexate levels by displacement of plasma proteins

Answer 13

Tetracyclines, phenytoin, phenothiazines,

chloramphenicol, NSAIDS, salicylates, and sulfonamides can all

Question 14

greater risk of pancytopenia on MTXX

Answer 14

Patients with renal disease, those using
NSAIDS or TMP/SMX, and those with no
folate supplementation are a

Question 15

Leukovorin (folinic acid) given under conditions of methotrexateinduced
myelosuppression with its ability

Answer 15

bypass dihydrofolate

reductase in the cell division pathway,

Question 16

Single morning dose steroids effect on HPA suppression

Answer 16

Reduce