TEST 7 Anti-cancer, antivirals and immunosuppressants

M.Phil. Part 1
Maximum Marks 70, Time 75 Minutes

1.
a) A 36 years old male is evaluated for kidney transplant, what is the most effective
drug for immunosuppression of rejection of the allografted kidney in this patient,
write down its mechanism of action and adverse effects, what could be done to
reduce these adverse effects? 4
b) Give a brief overview of Log-kill hypothesis of anticancer drugs 3
c) A 14 years old boy presents with acute lymphoblastic leukemia. One of the agents
you will be recommending causes the production of oxygen radicals which can
damage cardiac tissues when given at high doses. What agent is that? What is its
mechanism of action and what could be done to avoid this serious side effect? 3

2.
a) Classify the anti-neoplastics agents by representing them on the cell cycle
diagrammatically 4
b) A 45-year-old female treated for ovarian cancer develops difficulty hearing. Which
agent most likely caused these findings? What is its mechanism of action and
adverse effects? 3
c) Write down the mechanisms of development of resistance to various anti-cancer
drugs. 4

3.
a) A 41-year-old female is treated for endometrial cancer with tamoxifen. How is
tamoxifen useful in this situation, what are its adverse effects 3
b) Which of the anti-tumor drugs causes thymineless death of cells? What is its
mechanism uses and adverse effects? 3
d) A 45-year-old male on combination therapy for remissionmaintenance acute
lymphocytic leukemia develops suprapubic pain, dysuria, and hematuria. Evidence of
hemorrhage and inflammation is apparent on cystoscopy of the urinary bladder.
Which drugs is given in combination with other drugs, what is its mechanism of
action and other adverse effects? What is its antidote? 4

4.
a) Enumerate the Antitumor antibiotics; give mechanism of action and adverse
effects of anyone of them 3
b) A pregnant HIV-positive women presents to the obstetrics clinic for her first
prenatal visit. She is concerned about possible transmission of the virus to her fetus
and asks what if anything can be done to reduce the risk of transmitting the infection
to her growing child. Suggest the anti-retroviral regimen for her 3
c) A 35 years old male comes to the clinic complaining of painful lesion on his penis.
Physical examination reveals a vesicular lesion on glans of the penis. You explain to
the patient that he has contracted a viral sexually transmitted disease. What
medications can you prescribe? Give the mechanism and adverse effects of one of
them. 4
5.
a) Give the mechanism of action, uses and adverse effects of oseltamivir 4
b) Give the rationale of use of RhO(D) Immune Globulin in pregnancy. What are its
indications and mechanism? 3
c) Give the clinical uses of interferons 3
6.
a) A 34-year-old male with Hodgkin’s disease is treated with the (ABVD) regimen.
What drugs are included in this regimen? What is the mechanism of action of
vinblastine? What are its adverse effects? 3
b) Give the mechanism of action of Azathioprine 3
c) Tabulate the clinical uses of monoclinical antibodies 4

7.
a) Fill out the name/s of anti-cancer drug/s that cause each toxicity 5

Toxicity Drugs
Renal
Hepatic
Pulmonary
Cardiac
Neurological
Immunosuppressive
Hemorrhagic
cystitis
Pancreatitis
b) Give the mechanism of action, adverse effects and uses of Methotrexate, also
discuss how to minimize its adverse effects 5