Medical Pharmacology Practice Questions: Chapter 33-34 Hedgehog Pathway Inhibitor: Vismodegib (Erivedge)

Medical Pharmacology Practice Questions: Hedgehog Pathway Inhibitor: Vismodegib (Erivedge)

Hedgehog pathway:
1. Important in embryonic development
2. Central to pathogenesis of basal cell carcinoma (BCC).
3. Both
4. Neither
Most all sporadic basal cell carcinomas exhibit a mutation in hedgehog signaling which promotes disease.
1. True
2. Poles
Vismodegib (Erivedge):
1. Is classified as a competitive inhibitor at the SMO ("smoothens hedgehog") receptor.
2. Represents the first-in-class hedgehog signaling pathway inhibitor.
3. Both
4. Neither
Clinical indication/indications for vismodegib administration:
1. Basal cell lung cancer
2. Basal cell carcinoma
3. Both
4. Neither
Vismodegib may be appropriate for those adult patients with basal cell carcinoma who are not considered candidates for either radiation therapy or surgery.
1. True
2. False
Example/examples of toxicity/toxicity associated with vismodegib administration.
1. Neurotoxicity (vestibular)
2. Gastrointestinal toxicity
3. Renal toxicity
4. All of the above (A, B, C)
Administration of vismodegib to a pregnant woman may result in severe birth defects or embryofetal death.
1. True
2. False
Sonidegib:
1. A hedgehog pathway inhibitor similar to vismodegib.
2. Indicated for treatment of patients with locally advanced basal cell carcinoma which has occurred following surgical or radiation intervention
3. Both
4. Neither
Vismodegib metabolism:
1. Metabolized by the cytochrome P450 drug metabolizing system, particularly CYP2C9 and CYP3A4/5 isoforms.
2. Half-life: about 12 days after a single dose; about four days with continuous daily dosing.
3. Both
4. Neither
Vismodegib pharmacokinetics:
1. Oral absorption
2. Volume of distribution range 16.4 L to 26.6 L
3. Both
4. Neither