Cancer Pharmacology and Chemotherapy Flashcards

Which class of chemotherapy agents acts by cross-linking DNA strands to prevent replication?

Answer: Alkylating agents

Alkylating agents (e.g., cyclophosphamide, cisplatin) form covalent cross-links within and between DNA strands, blocking replication and transcription.

Cardiotoxicity is the major dose-limiting toxicity associated with which chemotherapy class?

Answer: Anthracyclines

Anthracyclines (doxorubicin, epirubicin) cause cumulative, dose-dependent cardiomyopathy through free-radical-mediated myocyte damage.

The mechanism of action of methotrexate is:

Answer: Inhibition of dihydrofolate reductase, depleting folate required for DNA synthesis

Methotrexate inhibits DHFR, preventing reduction of folate to its active form and thereby blocking thymidylate and purine synthesis.

Which taxane is approved for albumin-bound nanoparticle formulation to reduce hypersensitivity and improve delivery?

Answer: Nab-paclitaxel (Abraxane)

Nab-paclitaxel encapsulates paclitaxel in albumin nanoparticles, eliminating the Cremophor solvent that causes hypersensitivity reactions.

Peripheral neuropathy is the primary dose-limiting toxicity of which agent?

Answer: Oxaliplatin

Oxaliplatin causes acute cold-triggered sensory neuropathy and cumulative sensory peripheral neuropathy that limits the total dose deliverable.

Irinotecan causes severe delayed diarrhea through which mechanism?

Answer: Active SN-38 metabolite inhibiting topoisomerase I in intestinal epithelium

SN-38, the active metabolite of irinotecan, is excreted into the intestinal lumen via bile, where it damages epithelial cells causing delayed secretory diarrhea.