Chemotherapy drugs

Drug metabolism in humans usually results in a product that is:

Which of the following cytochrome isoforms is responsible for metabolizing the largest number of drugs?

Your 37-year-old patient has been diagnosed with a rare metastatic carcinoid tumor. This neoplasm is releasing serotonin, bradykinin, and several unknown peptides. The effects of serotonin in this patient are most likely to include:

Which drug does not activate opioid receptors, has been proposed as a maintenance drug in treatment programs for opioid addicts, and with a single oral dose, will block the effects of injected heroin for up to 48 h?

Which drug is a full agonist at opioid receptors with analgesic activity equivalent to morphine, a longer duration of action, and fewer withdrawal signs on abrupt discontinuance than morphine?

Total intravenous anesthesia with fentanyl has been selected for a frail elderly woman about to undergo cardiac surgery. Which statement about this anesthesia protocol is accurate?

A 32-year-old woman underwent segmental mastectomy for a breast tumor of 3 cm diameter. Lymph node sampling revealed 2 involved nodes. Because chemotherapy is of established value in her situation, she underwent postoperative treatment with antineoplastic drugs. The regimen consisted of doxorubicin followed by cyclophosphamide/methotrexate/fluorouracil. Adjunctive drugs included tamoxifen because the tumor cells were hormone receptor-positive. The chemotherapy undertaken by this patient caused acute hemorrhagic cystitis. Which drug was most likely to be responsible for this toxicity?

A 32-year-old woman underwent segmental mastectomy for a breast tumor of 3 cm diameter. Lymph node sampling revealed 2 involved nodes. Because chemotherapy is of established value in her situation, she underwent postoperative treatment with antineoplastic drugs. The regimen consisted of doxorubicin followed by cyclophosphamide/methotrexate/fluorouracil. Adjunctive drugs included tamoxifen because the tumor cells were hormone receptor-positive. After several cycles of chemotherapy, the patient was found to have a high resting pulse rate. A noninvasive radionuclide scan revealed evidence of cardiomyopathy. The drug that is most likely responsible for the cardiac toxicity is:

A patient with multiple myeloma was started on bortezomib after 2 rounds of other combination chemotherapy did not have any effect. What is the mechanism of action of bortezomib?

An adult patient is being treated for acute leukemia with a combination of anticancer drugs that includes cyclophosphamide, mercaptopurine, methotrexate, vincristine, and prednisone. He is also using ondansetron for emesis, a chlorhexidine mouthwash to reduce mucositis, and laxatives. The patient complains of “pins and needle" sensations in the extremities and muscle weakness. He is not able to execute a deep knee bend or get up out of a chair without using his arm muscles. He is also very constipated. If these problems are related to the chemotherapy, which of the following is the most likely causative agent?

A cancer cell that is resistant to the effects of both vincristine and methotrexate probably has developed the resistance as a result of which of the following mechanisms?

All the following agents have been used in drug regimens for the treatment of breast carcinoma. Which one has specific activity in a subset of female breast cancers?

Cyclosporine is effective in organ transplantation. Which of the following most accurately describes the immunosuppressant action of cyclosporine?

Which of the following is a widely used drug that suppresses cellular immunity, inhibits prostaglandin and leukotriene synthesis, and increases the catabolism of IgG antibodies?

A 36-year-old man presents with swollen, painful heels, nail changes, and left lower back pain that wakes him from sleep. The back pain gets better with exercise. He reports 1-2 h of morning stiffness. He has a history of psoriasis and psoriatic arthritis since age 12 years. You decide to change his current regimen of indomethacin to a biologic that targets TNF-α. Which of the following is a chimeric monoclonal antibody that binds to TNF-a and inhibits its action?

A 24-year-old woman underwent kidney transplantation. A week later, she developed alloantibody-mediated acute rejection (acute humoral rejection [AHR]). She was successfully treated with tacrolimus and a second drug that targets both B and T lymphocytes. Which of the following is an immunosuppressant that suppresses both B and T lymphocytes via inhibition of de novo synthesis of purines?

Which of the following is an immune modulator that increases phagocytosis by macrophages in patients with chronic granulomatous disease?

A 30-year-old woman undergoes abdominal surgery. In spite of minimal tissue damage, complete ileus (absence of bowel motility) follows, and she complains of severe bloating. She also finds it difficult to urinate. Mild cholinomimetic stimulation with bethanechol or neostigmine is often effective in relieving these complications of surgery. Neostigmine and bethanechol in moderate doses have significantly different effects on which one of the following?

Ms Brown has been treated for myasthenia gravis for several years. She reports to the emergency department complaining of recent onset of weakness of her hands, diplopia, and difficulty swallowing. She may be suffering from a change in response to her myasthenia therapy, that is, a cholinergic or a myasthenic crisis. Which of the following is the best drug for distinguishing between myasthenic crisis (insufficient therapy) and cholinergic crisis (excessive therapy)?

The primary mechanism of antibacterial action of the penicillins involves inhibition of?

A patient needs antibiotic treatment for native valve, culture-positive infective enterococcal endocarditis. His medical history includes a severe anaphylactic reaction to penicillin G during the last year. The best approach would be treatment with?

The mechanism of antibacterial action of tetracycline involves:

The primary mechanism of resistance of gram-positive organisms to macrolide antibiotics including erythromycin is:

A 26-year-old woman was treated for a suspected chlamydial infection at a neighborhood clinic. She was given a prescription for oral doxycycline to be taken for 14 d. Three weeks later, she returned to the clinic with a mucopurulent cervicitis. On questioning she admitted not having the prescription filled. The best course of action at this point would be to:

Regarding the mechanism of action of aminoglycosides, the drugs:

Which statement is accurate regarding the antibacterial action of the aminoglycoside amikacin?

Regarding the toxicity of aminoglycosides, which statement is accurate?

Trimethoprim-sulfamethoxazole is established to be effective against which of the following opportunistic infections in the AIDS patient?

Which statement about the fluoroquinolones is accurate?

Which statement about ciprofloxacin is accurate?

Which statement about fluconazole is accurate?

A 37-year-old woman with leukemia was undergoing chemotherapy with intravenous antineoplastic drugs. During treatment, she developed a systemic infection from an opportunistic pathogen. There was no erythema or edema at the catheter insertion site. A white vaginal discharge was observed. After appropriate specimens were obtained for culture, empiric antibiotic therapy was started with gentamicin, nafcillin, and ticarcillin intravenously. This regimen was maintained for 72 h, during which time the patient's condition did not improve significantly. Her throat was sore, and white plaques had appeared in her pharynx. On day 4, none of the cultures had shown any bacterial growth, but both the blood and urine cultures grew out Candida albicans. At this point, the best course of action is to:

A 27-year-old nursing mother is diagnosed as suffering from genital herpes. She has a history of this viral infection. Previously, she responded to a drug used topically. Apart from her current problem, she is in good health. Which drug to be used orally is most likely to be prescribed at this time?

More than 90% of this drug is excreted in the urine in intact form. Because its urinary solubility is low, patients should be well hydrated to prevent nephrotoxicity. Which drug is described?

Among NSAIDs, aspirin is unique because it:

Which of the following is an analgesic and antipyretic drug that lacks an anti-inflammatory action?

A 16-year-old girl comes to the emergency department suffering from the effects of an aspirin overdose. Which of the following syndromes is this patient most likely to exhibit as a result of this drug overdose?

Which of the following drugs is most likely to increase serum concentrations of conventional doses of methotrexate, a weak acid that is primarily cleared in the urine?

The main advantage of ketorolac over aspirin is that ketorolac:

An 18-month-old boy dies from an accidental overdose of acetaminophen. Which of the following is the most likely cause of this patient's death?

Which antifungal agent is MOST likely to cause renal insufficiency?

Which drug is relatively free of drug-drug interactions?

Which drug works by creating pores/channels in the fungal cell membrane?

A 32-year-old man presents to an outpatient clinic with a 5-day history of productive cough, purulent sputum, and shortness of breath. He is diagnosed with community-acquired pneumonia (CAP). It is noted that this patient has a severe ampicillin allergy (anaphylaxis). Which would be an acceptable treatment for this patient?

Which is a common adverse effect of cotrimoxazole?

The pharmacokinetics of a new drug are under study in a phase 1 clinical trial. Which statement about the distribution of drugs to specific tissues is most correct?