A. Ant psychotics
B. Benzodiazepines
C. Ethylene glycol
D. Methanol
E. Opiates
F. Organophosphates
G. Salicylates
H. Sympathomimetic
I. Tricyclic antidepressants
J. Volatile solvents
Select the most appropriate chemotherapeutic agent from the above list that corresponds with the following actions and side effects:
1) A drug disrupting microtubule leading to loss of deep tendon reflexes.
2) A drug inhibiting initiation of DNA synthesis resulting in conjunctivitis and cerebellar toxicity.
3) A drug resulting in dose related lung damage.
Don’t look at the answer before answering
Answer
J. Vincristine
G. Cytosine arabinoside
D. Bleomycin
Comments:
All cytotoxic agents have adverse effects. General side-effects include nausea, vomiting and bone marrow suppression, alopecia and stomatitis. More specific sideeffects are listed in the questions above. Alkylating agents such as Cyclophosphamide may cause a haemorrhagic cystitis. Asparaginase results in a dose related Pancreatitis.
The anthracyclines e.g. Doxorubicin and Daunorubicin are cardiotoxic, which is often very difficult to detect. Monitoring with echocardiograms is advised. Vincristine is an alkaloid agent and results in sensory motor neuropathy with long-term use. It also has an affect on the autonomic system resulting in severe constipation and paralytic ileus.It may also result in sensory changes with parathesis progressing to loss of tendon reflexes. Bleomycin is the main drug resulting in lung damage and occurs in up to 10%of patients. The damage is dose related.