Medical Pharmacology Chapters 33-34 Trabectedin

Trabectedin is classified as an alkylating agent binding to the minor DNA groove.
1. True
2. False
Trabectedin mechanism(s) of action:
1. Alters DNA binding protein activity
2. Affects transcription factors
3. Influences DNA repair processes
4. A & B
5. B & C
6. A & C
7. A, B & C
Trabectedin pharmacokinetics/pharmacodynamics:
1. Metabolized by the hepatic P450 microsomal drug metabolizing system utilizing primarily the CYP3A4 isoform.
2. Plasma half-life is about 30 hours.
3. Both
4. Neither
Trabectedin pharmacodynamic/pharmacokinetics:
1. Volume of distribution is >5000 L
2. Excretion (58%) is primarily in the feces (limited amount of unchanged drug).
3. Urinary excretion is limited at about 6% (very limited amount of unchanged drug).
4. A & B
5. B & C
6. A & C
7. A, B & C
Principal clinical use(s) of trabectedin
1. Liposarcoma
2. Leiomyosarcoma
3. Both
4. Neither
Hepatic enzyme elevation and fatigue is observed in about one third of patients following trabectedin administration unless dexamethosone pretreatment is provided.
1. True
2. False
The most frequently noted adverse effect(s) associated with trabectedin administration:
1. Neutropenia, thrombocytopenia (myelosuppression)
2. GI distress
3. Liver enzyme elevation
4. All of the above (A,B & C)
Trabectedin associated drug-drug interaction may be anticipated if trabectedin is given along with other drugs classified as cytochrome P450 inhibitors or enhancers.
1. True
2. False
Due to possible fetal harm, females of reproductive potential should employeffective contraception during treatment with trabectedin, continuing contraception for at least two months following the last trabectedin dose.
1. True
2. False
Trabectedin may be used in all soft tissue sarcomas (subtypes), although its primary use is in the "l-sarcomas" e.g. leiomyosarcoma and liposarcoma.
1. True
2. False