Exam 1- Antimetabolites/Alkylating agents/Platinum

Question 1

What phase of the cell cycle do antimetabolites primarily work in?

Answer 1

S phase

Question 2

Pyrimidine analogs

Answer 2

5-fluorouracil, capecitabine (uracil)

Cytarabine, gemcitabine (cytosine)

Question 3

Purine analogs

Answer 3

6-mercaptopurine

Question 3

Why is allopurinol contraindicated in patients taking 6-mercaptopurine?

Answer 3

Allopurinol is a xanthine oxidase inhibitor, which is the enzyme that breaks down 6-mercaptopurine

Question 4

What is the MOA of cytarabine?

Answer 4

competitively inhibits DNA polymerase and also incorporates into DNA to further inhibit DNA synthesis

Question 5

Are alkylating agents considered cell-cycle specific or non-cell cycle specific?

Answer 5

NON cell-cycle specific

Question 6

What is the most commonly used alkylating agent?

Answer 6

cyclophosphamide

Question 7

Which alkylating agent has more modest side effects than others?

Answer 7

cyclophosphamide

Question 8

Why does cyclophosphamide have only mild bone marrow toxicity?

Answer 8

high levels of aldehyde dehydrogenase in bone marrow, the enzyme that inactivates it

Question 9

Since cyclophosphamide is a prodrug, it requires _______________ by _____________

Answer 9

hydroxylation by cytochrome P450

Question 10

What is mesna used for?

Answer 10

mesna is used to inactivate acrolein metabolites (from cyclophosphamide) in the bladder

Question 11

Mitomycin C has _________ myelosuppression than cyclophosphamide

Answer 11

higher

Question 12

Why does cisplatin form intrastrand crosslinks, as opposed to interstrand?

Answer 12

The bond lengths and angles from cisplatin’s cis geometry

Question 13

Cisplatin has dose-limiting __________________

Answer 13

nephrotoxicity