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

Concerning the antifolate agent pemetrexed (Alimta), which one(s) of the following statements is/are correct?
1. Approved for use in combination therapy with cisplatin for mesothelioma treatment.
2. In monotherapy, permetrexed is considered second-line treatment and non-small cell lung cancer.
3. In combination with cisplatin, pemetrexed is considered first-line treatment in non-small cell lung cancer.
4. A & B
5. B & C
6. A & C
7. A, B & C
In patients whose non-small cell lung cancer has not progressed following for platinum-based chemotherapeutic cycles, pemetrexed is considered appropriate for subsequent maintenance treatment.
1. True
2. False
A significant adverse effect of pemetrexed is hand-foot syndrome.
1. True
2. False
Adverse effects associated with pemetrexed appear to be reduced through the use of folic acid and vitamin B12 supplementation.
1. True
2. False
The main mechanism of action of permetrexed:
1. Inhibition of dihydrofolate reductase
2. Inhibition of enzymes associated with purine nucleotide biosynthesis (de novo)
3. Inhibition of thymidylate synthase
Concerning pralatrexate (Folotyn),this agent has been approved for treatment of:
1. Refractory peripheral T-cell lymphoma
2. Relapsed T-cell lymphoma
3. Both
4. Neither
5-fluorouracil (5-FU):
1. Inactive in its parent form; therefore 5-FU is a "prodrug."
2. An active metabolite 5-fluoro-2'-deoxyuridine-5'-monophosphate (FdUMP) binds covalently with thymidylate synthase and the reduced folate 5, 10-methylenetetrahydrofolate which inhibits DNA synthesis.
3. Both
4. Neither
5-FU may also be metabolized to 5-fluorouridine-5'-triphosphate (FUTP) which following incorporation into RNA interrupts both RNA processing and mRNA translation.
1. True
2. False
Cytotoxicity involving the anticancer agent 5-FU (antimetabolite) results from:
1. Effects on DNA
2. Effects on RNA
3. Both
4. Neither
5-FU administration:
1. Bolus injection is preferable in order to reach high blood levels..
2. Most (about 80%) of it administered 5-FU dose is catabolized by dihydropyrimidine dehydrogenase (DPD)
3. Both
4. Neither