Medical Pharmacology: Cancer Chemotherapy Drugs: Anti-Metabolites Practice Questions

Fludarabine (Fludara) is useful in treating both non-Hodgkin's lymphoma in chronic lymphocytic leukemia.
1. True
2. False
Cladribine (Leustatin) is useful in treating: Non-Hodgkin's lymphoma, chronic lymphocytic leukemia and hairy cell leukemia
1. True
2. False
Clofarabine (Clolar) is useful in treating acute lymphoblastic leukemia.
1. True
2. False
Which one(s) represent resistance mechanism(s) to the action of methotrexate:
1. Increased formation of cytotoxic methotrexate polyglutamates
2. Reduced drug transport
3. Increased target enzyme (dihydrofolate reductase) by means of genetic mechanisms, such as gene amplification
4. A & B
5. B & C
6. A & C
7. A, B & C
Methotrexate oral bioavailability:
1. Saturable
2. Dependable dosing at all relevant dose levels
3. Both
4. Neither
Major route of methotrexate elimination:
1. Hepatic transformation followed by biliary excretion
2. Renal excretion
3. Both
4. Neither
Pemetrexed (Alimta):
1. Mainly uses the reduced folate carrier system for cell entry.
2. Pemetrexed is transformed to a pentaglutamate form in the cell; this form is considerably more potent compared to the parent compound.
3. Mainly cleared by renal excretion
4. A & B
5. B & C
6. A, B & C
Major toxic side effects associated with methotrexate include/includes:
1. Gastrointestinal toxicity
2. Myelosuppression
3. Both
4. Neither
Concerning antifolate toxicities:
1. These agents may be considered a direct renal tubule toxicant.
2. In the case of high-dose protocols, the likelihood of renal failure may be substantially reduced with urinary alkalinization and substantial hydration.
3. Both
4. Neither
Dose-limiting myelosuppression is a main toxicity of both pralatrexate and pemetrexed.
1. True
2. False