Optional Pharm Review Flashcards
What is the name of the cyclophosphamide and ifosfamide urologic toxic metabolite responsible for hemorrhagic cystitis?
Acrolein
amifostine
cisplatin antidote; rescues radiation-induced xerostomoia
dexrazoxane-
doxorubicin antidote (interacts with toxic iron free radicals to prevent cardiotoxicity)
Mesna
cyclophposphamid/ ifosfamide antidote
folinic acid (leucovorin)
MTX rescue
What is the main reason for giving allopurinol prophylactically prior to starting a course of chemotherapy?
Reduce the risk of hyperuricemia
With which of the following drugs should concomitant use of allopurinol be avoided, or be used with extra caution?
Bleomycin Cisplatin Cyclophosphamide Doxorubicin Mercaptopurine
Mercptopurine.
It will build up if allopurinol –> oxypurinol inhibits (uses up all the) xanthine oxidase
Only the PO dose needs to be adjusted because it’s the first-pass metabolism that is affected
A 30 y/o female being treated for ovarian cancer develops high frequency hearing loss and declining renal function in response to chemotherapy. Which of the following is the most likely causative agent?
Bleomycin Cisplatin Doxorubicin 5-Fluorouracil Paclitaxel
Cisplatin
A 41 y/o female is about to start her first course of adjuvant chemotherapy for metastatic breast cancer. Following premedication with ondansetron, she receives a combination of doxorubicin, cyclophosphamide, and fluorouracil. 24 hours later she starts a 10-day regimen with filgrastim. Which is the most likely reason for administration of filgrastim?
Reduce the risk and severity of chemotherapy-induced neutropenia
It is an analog to G-CSF
A 55 y/o male is taking methotrexate and has no history of cancer. What is the most likely condition for which this agent is being given?
Asthma or emphysema Hyperthyroidism Hyperuricemia or clinical gout Myasthenia gravis Rheumatoid arthritis
Rheumatoid arthritis
important to remember that dose is very different, so not as toxic in RA. More of an immunosuppressant
A patient undergoing cancer chemotherapy gets ondansetron for prophylaxis of drug-induced nausea and vomiting. Which statement best describes this drug’s main mechanism of action in this setting?
A. Activates µ-type opioid receptors in the chemoreceptor trigger zone
B. Blocks central serotonergic (5-HT₃) receptors
C. Blocks dopamine receptors
D. Blocks histamine H₁ receptors in the brainstem and inner ear
E. Suppresses gastric motility and acid secretion via muscarinic blockade
Blocks central serotonergic (5-HT₃) receptors
A 43 y/o HIV-positive male with a 6 month history of CD20+ diffuse large B-cell lymphoma, a subtype of non-Hodgkin lymphoma, presents to the oncology clinic for infusion of a combination of chemotherapeutic agents (this is his third of six scheduled infusions). His current CD4 count is 150 cells/mm3. Which agent is most likely to cause bone marrow suppression of additional leukocytes?
Bleomycin Prednisone Rituximab Vinblastine Vincristine
Vinblastine- blast the marrow
Rituximab
monoclonal antibody targeted at CD20
Administration of which of the following drug combinations is the best strategy for eliminating hypersensitivity reactions associated with administration of paclitaxel? Pretreatment with:
Diphenhydramine and dexamethasone Epoetin alpha and ibuprofen Filgrastim and oprelvekin Leucovorin and mesna Ondansetron and pegfilgrastim
Diphenhydramine and dexamethasone
dexamethasone inhibits the immune system
Chromosomal studies in a 56 y/o male indicate a (9;22) translocation. Which of the following is most likely used in his treatment?
Amifostine Anastrazole Gefitinib Imatinib Rituximab
Imatinib
A 37 y/o female recently had a large soft tissue sarcoma surgically resected from her retroperitoneum. She is to receive both radiation and chemotherapy. Mesna is included in her drug regimen. What is the mechanism of action of a likely additional drug included in her treatment?
Alkylation of DNA Destabilization of microtubules Inhibition of dihydrofolate reductase Inhibition of thymidylate synthase Intercalation of DNA
Alkylation of DNA (by cyclophosphamide)
What is the mechanism of action shared by targeted therapies available for treatment of HER2/neu positive breast carcinoma?
Inhibition of phosphorylation of a receptor tyrosine kinase
A 63 y/o female is diagnosed with metastatic colon carcinoma. Biopsy is positive for overexpression of the epidermal growth factor receptor (EGFR). Which agent is most appropriate?
Alemtuzumab Bevacizumab Cetuximab Gemtuzumab Rituximab Trastuzumab
Cetuximab
A 63 y/o female is diagnosed with metastatic colon carcinoma. An agent is used that blocks the interaction of vascular endothelial growth factor (VEGF) with the VEGF receptor. Which agent is described?
Alemtuzumab Bevacizumab Cetuximab Gemtuzumab Rituximab Trastuzumab
Bevacizumab
A 39 y/o female with acute lymphoblastic leukemia has been admitted to the hospital for induction chemotherapy, which includes the following:
Cytarabine – 5 g IV Q 12 hr for 8 doses
Vincristine – 2 mg IV push weekly
Prednisone – 100 mg/day
Asparaginase – 15,000 U/day for 14 days
Allopurinol – 300 mg/day
On day 3, she is confused and has difficulty performing a finger-to-nose neurologic examination. After 3 weeks, she complains of numbness in her hands and feet. An eyelid lag and ataxia are noted. What is the most likely cause of her mental status?
Allopurinol Asparaginase Cytarabine Prednisone Vincristine
Asparaginase in certain situations
and high dose Cytarabine cause mental issues
After 3 weeks, she complains of numbness in her hands and feet. An eyelid lag and ataxia are noted. What is the most likely cause of her paresthesia?
Allopurinol Asparaginase Cytarabine Prednisone Vincristine
Vincristine
