Medical Pharmacology Practice Questions: Chapter 33-34 Bruton Tyrosine Kinase (BTK) Inhibitor: Ibrutinib (Imbruvica)

Medical Pharmacology Practice Questions: Bruton Tyrosine Kinase (BTK) Inhibitor: Ibrutinib (Imbruvica)

Bruton tyrosine kinase (BTK):
1. Nonreceptor kinase important for correct be-lymphocyte development.
2. Important for B cell receptor signaling
3. Name for Ogden Bruton, a U.S. Navy pediatrician, who first described an ex-linked immunodeficiency due to BTK gene mutations.
4. A & B
5. B & C
6. A & C
7. A, B & C
Bruton tyrosine kinase:
1. Abnormalities in Bruton tyrosine kinase are connected with B-cell-related hematological malignancies
2. Inhibiting Bruton tyrosine kinase promotes through a number of biochemical steps apoptosis (programmed cell death).
3. Both
4. Neither
Inhibition of Bruton tyrosine kinase affects both B-and T cells.
1. True
2. False
Ibrutinib (Imbruvica):
1. Irreversible, potent Bruton tyrosine kinase inhibitor
2. Since B-cell signaling is central for malignant B cells survival, improved nib-mediated BTK inhibition reduces malignant B-cell proliferation and survival.
3. Both
4. Neither
Ibrutinib pharmacokinetics/pharmacodynamics:
1. Ibrutinib administration with food doubles absorption compared to administration on an empty stomach.
2. Ibrutinib is metabolized by the cytochrome P450 drug metabolizing system, utilizing mainly CYP3A and to a lesser extent CYP2D6 isoforms.
3. Both
4. Neither
Ibrutinib metabolism:
1. Excretion is mainly via the feces
2. Hepatic functional impairment would tend to increase patient exposure to a Ibrutinib.
3. Both
4. Neither
Ibrutinib resistance is mainly due to Pgp (P-glycoprotein 1) a.k.a. multidrug-resistant protein 1.
1. True
2. False
Clinical use/uses for Ibrutinib (Imbruvica):
1. MCL (mantle cell lymphoma)
2. CLL (chronic lymphocytic leukemia/small lymphocytic lymphoma)
3. WM (Waldenstrom macroglobulinemia)
4. A & B
5. B & C
6. A & C
7. A, B & C
Most common adverse effects/effects (greater than or equal to 20%) in patients with B-cell malignancies include/includes
1. Pyrexia
2. Neutropenia
3. Thrombocytopenia
4. Anemia
5. Diarrhea
6. Fatigue
7. All of the above
Cardiovascular side effects associated with ibrutinib:
1. Hypertension
2. Atrial fibrillation
3. Both
4. Neither