Anti-Toxicity Drugs Used in Cancer Terapy

ANTI-TOXICITY DRUGS USED IN CANCER THERAPY

Q. 1 Acute Gouty arthritis is seen early in treatment following
 A Probenecid
 B

Allopurinol

 C Colchicine
 D

Rasburicase

Q. 1 Acute Gouty arthritis is seen early in treatment following
 A Probenecid
 B

Allopurinol

 C Colchicine
 D

Rasburicase

Ans. B

Explanation:

Allopurinol REF: Goodman Gillman manual of pharmacology and therapeutics 2008 edition page 458

“The incidence of acute attacks of gouty arthritis mayincrease duringthe early months of allopurinol therapy as a consequence of mobilization of tissue stores of uric acid. Co-administration of colchicine helps suppress such acute attacks. After reduction of excess tissue stores of uric acid, the incidence of acute attacks decreases and colchicine can be discontinued”


Q. 2 Relative to filgrastim (G-CSF), sargramostim (GM-CSF)
 A Has greater  oral bioavailability
 B Is more  likely  to cause   thrombocytopenia 
 C Is more  likely  to elicit  an allergic reaction
 D Stimulates production of a wider  variety  of hematopoietic stem  cells
Q. 2 Relative to filgrastim (G-CSF), sargramostim (GM-CSF)
 A Has greater  oral bioavailability
 B Is more  likely  to cause   thrombocytopenia 
 C Is more  likely  to elicit  an allergic reaction
 D Stimulates production of a wider  variety  of hematopoietic stem  cells
Ans. D

Explanation:

Stimulates production of a wider variety of hematopoietic stem cells

GM-CSF  has  wider  biologic  activity  than  G-CSF; it stimulates  early myeloid stem cells in addition to cells destined become neutrophils.


Q. 3

All of the following drugs are known for its radio-protective properties, EXCEPT:

 A

Glucan

 B

Etoposide

 C

Amifostine

 D

Sodium Selenite

Q. 3

All of the following drugs are known for its radio-protective properties, EXCEPT:

 A

Glucan

 B

Etoposide

 C

Amifostine

 D

Sodium Selenite

Ans. B

Explanation:

Common drugs with radioprotective effects are Amifostine (WR-2721) and Glucan.

Sodium Selenite at certain concentrations protects aginst radiation induced mutation.

Ref: Complementary Oncology: Adjunctive Methods in The Treatment of Cancer By J. Beuth, Ralph W. Moss Study: Brizel et al 2003, 2007, Page 175; Advances in Radiation Oncology in Lung Cancer By Branislav Jeremic, 2011, Pages 225-226; Forum on Immunomodulators  By M. Guenounou, Page 56.

Quiz In Between


Q. 4

Filgrastim is used in treatment of:

 A

Anemia

 B

Neutropenia

 C

Malaria

 D

Filarial

Q. 4

Filgrastim is used in treatment of:

 A

Anemia

 B

Neutropenia

 C

Malaria

 D

Filarial

Ans. B

Explanation:

Filgrastim is a recombinant human granulocyte colony stimulating factor (G-CSF) which is a 175 – aminoacid glyco-protein.

It differs from the natural granulocyte stimulating factor due to its lack in glycosylation and the presence of an extra N-terminal methionine. It has proved to be effective in the treatment of severe neutropenia.

Ref: Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 11th Edition, Pages 1429-32; Immunopharmacology By Manzoor M. Khan, Pages 49-50


Q. 5

Fosaprepitant is used as:

 A

Anitidepressant

 B

Anitiemetic

 C

Antihypertensive

 D

Diuretic

Q. 5

Fosaprepitant is used as:

 A

Anitidepressant

 B

Anitiemetic

 C

Antihypertensive

 D

Diuretic

Ans. B

Explanation:

Neurokinin 1 (NK1)-receptor antagonists have antiemetic properties that are mediated through central blockade in the area postrema.
Aprepitant (an oral formulation) is a highly selective NK1-receptor antagonist that crosses the blood-brain barrier and occupies brain NK1 receptors. It has no affinity for serotonin, dopamine, or corticosteroid receptors.
Fosaprepitant is an intravenous formulation that is converted within 30 minutes after infusion to aprepitant.
 
Ref: Katzung 11th edition Chapter 60.

Q. 6

All of the following is used as antiemetic, EXCEPT:

 A

Granisetron

 B

Dolasetron

 C

Palonosetron

 D

Alosetron

Q. 6

All of the following is used as antiemetic, EXCEPT:

 A

Granisetron

 B

Dolasetron

 C

Palonosetron

 D

Alosetron

Ans. D

Explanation:

Alosetron is a 5-HT3 antagonist that has been approved for the treatment of patients with severe IBS with diarrhea.
Four other 5-HT3 antagonists (ondansetron, granisetron, dolasetron, and palonosetron) have been approved for the prevention and treatment of nausea and vomiting (see Antiemetics); however, their efficacy in the treatment of IBS has not been determined.
The differences between these 5-HT3 antagonists that determine their pharmacodynamic effects have not been well studied
 
Ref: Katzung 11th edition Chapter 60.

Quiz In Between


Q. 7

Aprepitant is used as:

 A

Anitidepressant

 B

Antiemetic

 C

Antihypertensive

 D

Diuretic

Q. 7

Aprepitant is used as:

 A

Anitidepressant

 B

Antiemetic

 C

Antihypertensive

 D

Diuretic

Ans. B

Explanation:

The actions of substance P and neurokinins A and B are mediated by three G protein-coupled tachykinin receptors designated NK 1, NK 2, and NK 3.

Several nonpeptide NK1 receptor antagonists have been developed.

These compounds are highly selective and orally active, and enter the brain.

Recent clinical trials have shown that these antagonists may be useful in treating depression and other disorders and in preventing chemotherapy-induced emesis.

The first of these to be approved for the prevention of chemotherapy-induced nausea and vomiting is aprepitant.

Ref: Katzung, 11th edition, Chapter 17.


Q. 8

Ondansetron acts by –

 A

Acting on CTZ

 B

5-HT3 antagonist

 C

Increases GIT motility

 D

a and b

Q. 8

Ondansetron acts by –

 A

Acting on CTZ

 B

5-HT3 antagonist

 C

Increases GIT motility

 D

a and b

Ans. D

Explanation:

Ans. is ‘a’ i.e., Acting on CTZ; ‘b’ i.e., 5-HT3 antagonist

o Ondansetron blocks the deoplarizing action of 5HT through 5-HT3 receptors on vagal afferents in the gut as well as in NTS and CTZ. It blocks emetogenic impulses both at their peripheral origin and their central relay.


Q. 9

Granisetron is used in?

 A

Motion sickness

 B

Sedation in endoscopy

 C

Chemotherapy induced nausea & vomiting

 D

Gastroesophageal reflux disease

Q. 9

Granisetron is used in?

 A

Motion sickness

 B

Sedation in endoscopy

 C

Chemotherapy induced nausea & vomiting

 D

Gastroesophageal reflux disease

Ans. C

Explanation:

Ans. is ‘c’ i.e., Chemotherapy induced nausea & vomiting

5-HT3 blockers (e.g. ondansetron, granisetron etc) are the drugs of choice for chemotherapy induced nausea and vomiting.

Quiz In Between


Q. 10

All of the following are true about Ondansetron except‑

 A

Drug of choice for chemotherapy induced vomiting

 B

Dopamine antagonist

 C

5HT3 antagonist

 D

Acts on CTZ

Q. 10

All of the following are true about Ondansetron except‑

 A

Drug of choice for chemotherapy induced vomiting

 B

Dopamine antagonist

 C

5HT3 antagonist

 D

Acts on CTZ

Ans. B

Explanation:

Ans. is ‘b’ i.e., Dopamine antagonist

Ondansetron is 5-HT3 receptor antagonist at CTZ and NTS, as well as in GIT.


Q. 11

All of the following statements about `Aprepitant’ are true, except:

 A

Agonist at Neurokinin receptor (NK1)

 B

Crosses the blood brain barrier

 C

Metabolized by CyP3A4 pathway

 D

Ameliorates nausea and vomiting of chemotherapy

Q. 11

All of the following statements about `Aprepitant’ are true, except:

 A

Agonist at Neurokinin receptor (NK1)

 B

Crosses the blood brain barrier

 C

Metabolized by CyP3A4 pathway

 D

Ameliorates nausea and vomiting of chemotherapy

Ans. A

Explanation:

Ans is ‘a’ i.e. Agonist at Neurokinin receptor (NK1)

Aprepitant is an antiemetic substance that belongs to a class of drugs called substance P antagonists. o The compound mediates its effect by blocking the neurokinim 1 (NK1) receptor.

o Aprepitant crosses the blood brain barrier.

o Aprepitant is used for chemotherapy induced nausea & vomiting (CINY), and post- operative nausea & vomiting (PONV).

o After absorption aprepitant is bound extensively to plasma proteins (>95%); it is metabolized avidly, primarily by hepatic CYP 3A4 and is excreted in the stools.


Q. 12

Mesna is given with cyclophosphamide to

 A

Increase absroption

 B

Decrease excretion

 C

Amolierate haemorrhagic cystitis

 D

Decrease metabolism

Q. 12

Mesna is given with cyclophosphamide to

 A

Increase absroption

 B

Decrease excretion

 C

Amolierate haemorrhagic cystitis

 D

Decrease metabolism

Ans. C

Explanation:

Ans. is ‘c’ i.e., Ameliorate haemorrhagic cystitis

Quiz In Between


Q. 13

Anti cancer drug causing nephrotoxicity ‑

 A

Cyclophosphamide

 B

Busulfan

 C

Cisplatin

 D

Procarbazine

Q. 13

Anti cancer drug causing nephrotoxicity ‑

 A

Cyclophosphamide

 B

Busulfan

 C

Cisplatin

 D

Procarbazine

Ans. C

Explanation:

Ans. is ‘c’ i.e., Cisplatin


Q. 14

Which antineoplastic agent is an antifolate drug

 A

Methotrexate

 B

Adriamycin

 C

Vincristine

 D

Cyclophosphamide

Q. 14

Which antineoplastic agent is an antifolate drug

 A

Methotrexate

 B

Adriamycin

 C

Vincristine

 D

Cyclophosphamide

Ans. A

Explanation:

Ans. is ‘a’ i.e., Methotrexate


Q. 15

Anticancer drugs having highest emetogenic potential –

 A

Cisplatin

 B

Vincristine

 C

Mthotrexate

 D

Busulfan

Q. 15

Anticancer drugs having highest emetogenic potential –

 A

Cisplatin

 B

Vincristine

 C

Mthotrexate

 D

Busulfan

Ans. A

Explanation:

Ans. is ‘a’ i.e., Cisplatin

Quiz In Between


Q. 16

Peripheral neuropathy may occur with the use of all the following except –

 A

Vincristine

 B

Cisplatin

 C

L-Asparaginase

 D

Procarbazine

Q. 16

Peripheral neuropathy may occur with the use of all the following except –

 A

Vincristine

 B

Cisplatin

 C

L-Asparaginase

 D

Procarbazine

Ans. C

Explanation:

Ans. is ‘c’ i.e., L-Asparaginase

Drug causing peripheral necropathy

Amiodarone                 Demeclocycline          Isoniazid

Chloramphenicol         Disopyramide             Methysergide

Chloroquine                 Ethambutol                 Metronidazole

Cisplatin                     Ethionamide               Vincristine

Clioguinol                   Glutethemide              Tricyclic antidepressant

Clofibrate                    Hydralazine                Tolbutamide

Paclitaxol                  Chlorpropamide

Mustine                     Nalidixic acid                Nitrofurantoin

Perhexiline                 Phenelzine                  Phenytoin

Streptomycin             Procarbazine               Polymyxin, colistin

Stavudine                   Didanosine               Zalcitabine


Q. 17

Pulmonary fibrosis is the most common complication after treatment with –

 A

6- mercaptopurine

 B

Vincristine

 C

Bleomycin

 D

Adriamycine

Q. 17

Pulmonary fibrosis is the most common complication after treatment with –

 A

6- mercaptopurine

 B

Vincristine

 C

Bleomycin

 D

Adriamycine

Ans. C

Explanation:

Ans. is ‘c’ i.e., Bleomycin

Drugs causing pulmonary fibrosis

Acyclovir                Busulphan             Cyclophosphamide             Gold                                Mitomycin C

Amiodarone          Carmustine           Nitrofurantoin                     Melphalan                       Sulfonamides

Bleomycin             Chlorambucil        Procarbazine                     Methysergide                Penicillamine Methotrexate


Q. 18

Allopurinol is used in organ preservation as:

 A

Antioxidant

 B

Preservative

 C

Free radical scavenger

 D

Precursor for energy metabolism

Q. 18

Allopurinol is used in organ preservation as:

 A

Antioxidant

 B

Preservative

 C

Free radical scavenger

 D

Precursor for energy metabolism

Ans. C

Explanation:

Ans is c i.e. Free radical scavenger 

Organ preservation is the supply line for organ transplantation. Currently, the liver, pancreas, and kidney can be successfully preserved for up to two days by flushing the organs with the University of Wisconsin (UW) solution and storing them at hypothermia (0-5° C). The UW solution is effective because it uses a number of cell impermeant agents (lactobionic acid, raffinose, hydroxyethyl starch) that prevent the cells from swelling during cold ischemic storage. Additionally, the UW solution contains glutathione, allopurinol and adenosine, agents that may stimulate recovery of normal metabolism upon reperfusion by augmenting the antioxidant capacity of the organs (glutathione) or by stimulating high-energy phosphate generation (adenosine) upon reperfusion and allopurinol as free-radical scavenger.

  • Glutathione            as antioxidant
  • Adenosine              as precursor for energy metabolism
  • Allopurinol              as free-radical scavenger

Quiz In Between


Q. 19

All of the following are true about Hypercalcemia, except:

 A

Management of primary cause

 B

Management of primary cause

 C

IV fluid with furosemide is given

 D

Pamidronate is not effective

Q. 19

All of the following are true about Hypercalcemia, except:

 A

Management of primary cause

 B

Management of primary cause

 C

IV fluid with furosemide is given

 D

Pamidronate is not effective

Ans. D

Explanation:

Answer is D (Pamidronate is not effective):

Pamidronate is a second generation hiphosphonate that is approved for intravenous use in the treatment of hypercalcemia.


Q. 20

Allopurinol acts by inhibiting:       

 A

Uric acid carboxylase

 B

Hypoxanthine oxidase

 C

Uric acid synthase

 D

Xanthine oxidase

Q. 20

Allopurinol acts by inhibiting:       

 A

Uric acid carboxylase

 B

Hypoxanthine oxidase

 C

Uric acid synthase

 D

Xanthine oxidase

Ans. D

Explanation:

Q. 21

Pulmonary fibrosis is a complication of:

March 2011, March 2012, September 2012, March 2013

 A

Methotrexate

 B

Doxorubicin

 C

Cisplatin

 D

Busulfan

Q. 21

Pulmonary fibrosis is a complication of:

March 2011, March 2012, September 2012, March 2013

 A

Methotrexate

 B

Doxorubicin

 C

Cisplatin

 D

Busulfan

Ans. D

Explanation:

Ans. D: Busulfan

Incidence of thrombocytopenia is higher with use of Busulfan. Prolonged administration may cause amenorrhoea, wasting, pigmentation, gynaecomastia, anhydrosis and pulmonary fibrosis.

Busulfan

  • Busulfan is a cell cycle non-specific alkylating antineoplastic agent, in the class of alkyl sulfonates.
  • Its chemical designation is 1,4-butanediol dimethanesulfonate.
  • Currently, its main uses are in bone marrow transplantation, especially in chronic myelogenous leukemia (CML), where it is used as a conditioning drug.
  • Its mechanism of action through alkylation produces guanine-adenine intrastrand crosslinks.
  • This occurs through an SN2 reaction in which the relatively nucleophilic guanine N7 attacks the carbon adjacent to the mesylate leaving group.
  • This kind of damage cannot be repaired by cellular machinery and thus the cell undergoes apoptosis.

Quiz In Between


Q. 22

Mechanism of action of allopurinol:

September 2005

 A

Inhibits the synthesis of uric acid

 B

Inhibits tubular resorption of uric acid

 C

Antinflammatory action

 D

Increases phagocytosis of urate crystals

Q. 22

Mechanism of action of allopurinol:

September 2005

 A

Inhibits the synthesis of uric acid

 B

Inhibits tubular resorption of uric acid

 C

Antinflammatory action

 D

Increases phagocytosis of urate crystals

Ans. A

Explanation:

Ans. A: Inhibits the synthesis of uric acid

Allopurinol is a structural isomer of hypoxanthine (a naturally occurring purine in the body) and is an enzyme inhibitor, inhibiting xanthine oxidase.

Xanthine oxidase is responsible for the successive oxidation of hypoxanthine and xanthine resulting in the production of uric acid, the product of human purine metabolism.

In addition to blocking uric acid production, inhibition of xanthine oxidase causes an increase in hypoxanthine and xanthine, which are converted to closely related purine ribotides adenosine and guanosine monophosphates.

Increased levels of these ribotides cause feedback inhibition of amidophosphoribosyl transferase, the first and rate-limiting enzyme of purine biosynthesis.

Allopurinol therefore decreases both uric acid formation and purine synthesis.


Q. 23

Which of following drug inhibits xanthine oxidase:

September 2007

 A

Probenicid

 B

Quiniarcine

 C

Allopurinol

 D

Sulfinpyrazone

Q. 23

Which of following drug inhibits xanthine oxidase:

September 2007

 A

Probenicid

 B

Quiniarcine

 C

Allopurinol

 D

Sulfinpyrazone

Ans. C

Explanation:

Ans. C: Allopurinol

Xanthine oxidase is involved in purine metabolism.

Inhibition of xanthine oxidase reduces the production of uric acid, and several medications that inhibit xanthine oxidase are indicated for treatment of hyperuricemia and related medical conditions including gout.

Xanthine oxidase inhibitors are:

a. Purine analogues include allopurinol, oxypurinol, and tisopurine.

b. Others include febuxostat and inositols (phytic acid and myo-inositol).


Q. 24

Which of the following is used for medical adrenalectomy:          

September 2009

 A

Metyrapone

 B

Ketoconazole

 C

Aminoglutethimide

 D

All of the above

Q. 24

Which of the following is used for medical adrenalectomy:          

September 2009

 A

Metyrapone

 B

Ketoconazole

 C

Aminoglutethimide

 D

All of the above

Ans. D

Explanation:

Ans. D: All of the above

Medical care for Cushing syndrome can be summarized as follows:

  • Agents that inhibit steroidogenesis, such as mitotane, ketoconazole, metyrapone, aminoglutethimide, trilostane, and etomidate, have been used to cause medical adrenalectomy. These medications are used rarely and often are toxic at the doses required to reduce cortisol secretion. Efficacy of these medical interventions can be assessed with serial measurements of 24-hour urinary free cortisol.

–        Patients receiving these medications may require glucocorticoid replacement to avoid adrenal insufficiency.

–        Metyrapone and trilostane are agents that competitively inhibit a single steroidogenic enzyme. Ketoconazole and aminoglutethimide act at several sites.

  • Because ACTH production may persist or increase in patients with Cushing disease, radiation therapy of the pituitary is often required after unsuccessful initial therapy, either surgical or medical. These agents have higher efficacy when used in combination because they may act synergistically.
  • Ketoconazole is probably the most popular and effective of these agents for long-term use and usually is the agent of choice

Quiz In Between


Q. 25

True regarding ondansetron are all of the following except:         

March 2010

 A

Antiemetic of choice for chemotherapy induced vomiting

 B

5-HT3 receptor antagonist

 C

Significant drug interactions

 D

May have 5-HT4 antagonism

Q. 25

True regarding ondansetron are all of the following except:         

March 2010

 A

Antiemetic of choice for chemotherapy induced vomiting

 B

5-HT3 receptor antagonist

 C

Significant drug interactions

 D

May have 5-HT4 antagonism

Ans. C

Explanation:

Ans. C: Significant Drug Interactions

Ondansetron is the prototype of new class of antiemetic drugs developed to control chemotherapy/radiotherapy induced vomiting, and later found to be highly effective in postoperative nausea and vomiting as well.

It blocks the action of 5-HT through 5-HT3 receptors on vagal afferents in the GIT as well as in NTS and CTZ. A minor 5-HT4 antagonistic action has also been shown.

It is hydroxylated by CYP 1A2, 2D6 and 3A, but no clinically significant drug interactions have been noted.


Q. 26

Mechanism of action of allopurinol is:        

March 2011

 A

Inhibits adenosine deaminase

 B

Inhibits phospho-di-esterase

 C

Inhibits uricase

 D

Inhibits xanthine oxidase

Q. 26

Mechanism of action of allopurinol is:        

March 2011

 A

Inhibits adenosine deaminase

 B

Inhibits phospho-di-esterase

 C

Inhibits uricase

 D

Inhibits xanthine oxidase

Ans. D

Explanation:

Ans. D: Inhibits Xanthine Oxidase


Q. 27

Anticancer drug with disulfuram like action –

 A

Procarbazine

 B

Nitrosurea

 C

5 FU

 D

Methotrexate

Q. 27

Anticancer drug with disulfuram like action –

 A

Procarbazine

 B

Nitrosurea

 C

5 FU

 D

Methotrexate

Ans. A

Explanation:

Ans. is ‘a’ i.e., Procarbazine

Disulfiram like reaction

  • Certain drugs when taken concurrently with alcohol produce disulfiram like actions.
  • That means these drugs produce similar distressing symptoms as disulfiram, when taken with alcohol → flushing, burning sensation, throbbing headache, prespiration, unesasiness, tightness in chest, vomiting, dizziness, visual disturbances, mental confusion, postural fainting and circulatory collapse.

The drugs causing Disulfiram like actions

  1. Chlorpropramide            
  2. Animal charcol
  3. Cephalosporins (Cefoperazone, moxalactam, cefamandole) 
  4. Griseofulvin
  5. Metronidazole         
  6. Procarbazine
  7. Citrated calcium carbamide  
  8. Tinidazine
  9. Cynamide

Quiz In Between


Q. 28

Hand and foot syndrome is due to ‑

 A

Vincristine

 B

Cisplatin

 C

5 FU

 D

Azathioprine

Q. 28

Hand and foot syndrome is due to ‑

 A

Vincristine

 B

Cisplatin

 C

5 FU

 D

Azathioprine

Ans. C

Explanation:

Ans. is ‘c’ i.e., 5 FU


Q. 29

SIADH is not caused by ‑

 A

Vincristine

 B

Actinomycin D

 C

Vinblastine

 D

Cyclophosphamide

Q. 29

SIADH is not caused by ‑

 A

Vincristine

 B

Actinomycin D

 C

Vinblastine

 D

Cyclophosphamide

Ans. B

Explanation:

Ans. is ‘b’ i.e., Actinomycin D


Q. 30

Amifostine is a:

 A

Radiosensitizer

 B

Radioprotector

 C

Radiomodifier

 D

Radiomimetic

Q. 30

Amifostine is a:

 A

Radiosensitizer

 B

Radioprotector

 C

Radiomodifier

 D

Radiomimetic

Ans. B

Explanation:

Ans. b. Radioprotector

Radiotherapy

Radiosensitiser Radiation Protectors
OxygenQmost effective radiosensitiser) AmifostineQ
MetronidazoleQ, misonidazole, tinidazole IL-1Q
5-FUQ(non-hypoxic cell sensitizer) GM-CSFQ
HydroxyureaQ(non-hypoxic cell sensitizer)  
BUDR and IUDRQ (non-hypoxic cell sensitizer)  
CisplatinQ paclitaxel, gemcitabine  
MitomycinQ, topotecan, vinorelbine  
Dactinom (Actinomycin D)Q  
  • flypoxic cells are resistant to radiotherapy`.
  • Augmentation of oxygen is the basis of radiosensitizationo.

Quiz In Between


Q. 31

Hemorrhagic cystitis is seen with ‑

 A

Cyclophosphamide

 B

Busulfan

 C

Ketoprofen

 D

5FU

Q. 31

Hemorrhagic cystitis is seen with ‑

 A

Cyclophosphamide

 B

Busulfan

 C

Ketoprofen

 D

5FU

Ans. A

Explanation:

Ans. is ‘a’ i.e., Cyclophosphamide > ‘b’ i.e., Busulfan 

  • Hemorrhagic cystitis due to cyclophosphamide is attributed to the presence of its metabolite ACROLEIN in urine.
  • Cyclophosphamide is inactive as such : transformation into active metabolites (aldophosphamide, phoshomide mustard) occurs in the liver, and a wide range of antitumor actions is exerted.
  • Cyclophosphamide has prominant immunosuppressant action.
  • Cyclophosphamide may also cause cardiac dysfunction, pulmonary toxicity and syndrome of inappropriate ADH secretion.

Other drugs causing hemorrhagic cystitis

Carmustine     Extended spectrum penicillins  Vincristine

Chlorambucil  Nitrogen mustard                    Busulfan


Q. 32

Peripheral neuropathy as a side effect is caused by which of the following anti cancer drugs ‑

 A

Vincristine

 B

Cyclophosphamide

 C

Etoposide

 D

Irinotecan

Q. 32

Peripheral neuropathy as a side effect is caused by which of the following anti cancer drugs ‑

 A

Vincristine

 B

Cyclophosphamide

 C

Etoposide

 D

Irinotecan

Ans. A

Explanation:

Ans. is ‘a’ i.e., Vincristine

Vincristine (Oncovin)

  • Alkaloid derived from Vinca rosae.
  • Vincristine belongs to the plant alkaloid group of anticancer.
  • Rapidly acting anticancer
  • This class of drugs are also known as spindle poison.
  • These drugs bind to microtubular protein (tubulin)
  • The drug-tubulin complex then attaches itself to microtubules and causes depolymerization of microtubules.
  • Depolymerization of microtubule causes
  1. Mitotic arrest at metaphase
  2. Dissolution of mitotic spindle
  3. Interference with chromosome segregation
  • Useful for inducing remission in childhood ALL (not useful in maintenance therapy)
  • It can also be used for pediatric solid tumors (Wilm’s tumor, neuroblastoma, rhabdomyosarcoma) and lymphomas. 
  • Prominent adverse effects‑

Peripheral neuropathy  Alopecia   SIADH

  • Vincristine is a marrow sparing drug but some times it may cause myelosuppression which is very less than vinblastin. 
  • Indications of vincristine‑

Hodgkins disease           Wilms’s tumour       Carcinoma lung

Non hodgkin:s. disease  Ewing’s sarcoma      Myeloma

  • Vinblastine and vinorelbine are other vinca alkaloids.
  • o Vinblastine’s most important clinical use is the curative therapy of metastatic testicular tumor.
  • o Vinblastine can cause bone marrow suppression (in contrast with vincristin), alopecia, and nausea & vomiting. o As they arrest mitosis, all vinca alkaloids act in M phase.

Quiz In Between



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