HESI B
Cyclophosphamide IV
therapy Review Exam
88%
Q&A
2024
,1. What is the mechanism of action of cyclophosphamide in cancer
treatment?
a) It inhibits DNA synthesis by cross-linking DNA strands
b) It blocks the cell cycle by interfering with microtubule formation
c) It induces apoptosis by activating caspases
d) It stimulates the immune system by releasing cytokines
Answer: A. Cyclophosphamide is an alkylating agent that forms covalent
bonds between adjacent DNA strands, preventing DNA replication and
transcription.
Rationale: B, C and D are mechanisms of action of other classes of
anticancer drugs, such as taxanes, anthracyclines and immunotherapy
agents.
2. What are the main adverse effects of cyclophosphamide?
a) Nausea, vomiting and diarrhea
b) Hemorrhagic cystitis, bone marrow suppression and alopecia
c) Cardiotoxicity, hepatotoxicity and nephrotoxicity
d) Peripheral neuropathy, mucositis and skin rash
Answer: B. Cyclophosphamide can cause hemorrhagic cystitis due to the
formation of acrolein, a toxic metabolite that irritates the bladder mucosa.
It can also cause bone marrow suppression, leading to anemia, leukopenia
and thrombocytopenia, and alopecia due to damage to hair follicles.
Rationale: A, C and D are adverse effects of other classes of anticancer
drugs, such as platinum compounds, anthracyclines and taxanes.
3. How can hemorrhagic cystitis be prevented or treated in patients
receiving cyclophosphamide?
a) By administering mesna, a sulfhydryl compound that binds to acrolein
b) By administering allopurinol, a xanthine oxidase inhibitor that reduces
uric acid production
c) By administering amifostine, a cytoprotective agent that scavenges free
radicals
d) By administering leucovorin, a folinic acid derivative that enhances
DNA repair
Answer: A. Mesna is a specific antidote for cyclophosphamide-induced
hemorrhagic cystitis. It forms a complex with acrolein in the urine,
rendering it inactive and less toxic to the bladder mucosa.
, Rationale: B, C and D are cytoprotective agents for other classes of
anticancer drugs, such as platinum compounds, alkylating agents and
antimetabolites.
4. What is the recommended dose of cyclophosphamide for cancer
treatment?
a) 50-100 mg/m2 daily for 14 days
b) 100-200 mg/m2 every 3-4 weeks
c) 500-1000 mg/m2 every 2-3 weeks
d) 1500-2000 mg/m2 every 4-6 weeks
Answer: C. The usual dose of cyclophosphamide for cancer treatment is
500-1000 mg/m2 given intravenously every 2-3 weeks, depending on the
type and stage of cancer, the patient's response and tolerance, and the
combination with other anticancer drugs.
Rationale: A, B and D are either too low or too high doses of
cyclophosphamide for cancer treatment.
5. What are the contraindications for cyclophosphamide use?
a) Pregnancy, lactation and hypersensitivity
b) Renal impairment, hepatic impairment and infection
c) Diabetes mellitus, hypertension and peptic ulcer disease
d) All of the above
Answer: D. Cyclophosphamide is contraindicated in patients who are
pregnant or lactating, as it can cause fetal harm or pass into breast milk. It
is also contraindicated in patients who have hypersensitivity to
cyclophosphamide or any of its components. Cyclophosphamide should
be used with caution in patients who have renal impairment, hepatic
impairment or infection, as it can worsen these conditions or increase the
risk of complications.
Rationale: C is not a contraindication for cyclophosphamide use, but
rather a comorbidity that may require dose adjustment or monitoring.
6. What are the drug interactions of cyclophosphamide?
a) It increases the effects of anticoagulants, such as warfarin
b) It decreases the effects of immunosuppressants, such as cyclosporine
c) It enhances the toxicity of other anticancer drugs, such as doxorubicin
d) All of the above
Answer: D. Cyclophosphamide can interact with several drugs that affect
Cyclophosphamide IV
therapy Review Exam
88%
Q&A
2024
,1. What is the mechanism of action of cyclophosphamide in cancer
treatment?
a) It inhibits DNA synthesis by cross-linking DNA strands
b) It blocks the cell cycle by interfering with microtubule formation
c) It induces apoptosis by activating caspases
d) It stimulates the immune system by releasing cytokines
Answer: A. Cyclophosphamide is an alkylating agent that forms covalent
bonds between adjacent DNA strands, preventing DNA replication and
transcription.
Rationale: B, C and D are mechanisms of action of other classes of
anticancer drugs, such as taxanes, anthracyclines and immunotherapy
agents.
2. What are the main adverse effects of cyclophosphamide?
a) Nausea, vomiting and diarrhea
b) Hemorrhagic cystitis, bone marrow suppression and alopecia
c) Cardiotoxicity, hepatotoxicity and nephrotoxicity
d) Peripheral neuropathy, mucositis and skin rash
Answer: B. Cyclophosphamide can cause hemorrhagic cystitis due to the
formation of acrolein, a toxic metabolite that irritates the bladder mucosa.
It can also cause bone marrow suppression, leading to anemia, leukopenia
and thrombocytopenia, and alopecia due to damage to hair follicles.
Rationale: A, C and D are adverse effects of other classes of anticancer
drugs, such as platinum compounds, anthracyclines and taxanes.
3. How can hemorrhagic cystitis be prevented or treated in patients
receiving cyclophosphamide?
a) By administering mesna, a sulfhydryl compound that binds to acrolein
b) By administering allopurinol, a xanthine oxidase inhibitor that reduces
uric acid production
c) By administering amifostine, a cytoprotective agent that scavenges free
radicals
d) By administering leucovorin, a folinic acid derivative that enhances
DNA repair
Answer: A. Mesna is a specific antidote for cyclophosphamide-induced
hemorrhagic cystitis. It forms a complex with acrolein in the urine,
rendering it inactive and less toxic to the bladder mucosa.
, Rationale: B, C and D are cytoprotective agents for other classes of
anticancer drugs, such as platinum compounds, alkylating agents and
antimetabolites.
4. What is the recommended dose of cyclophosphamide for cancer
treatment?
a) 50-100 mg/m2 daily for 14 days
b) 100-200 mg/m2 every 3-4 weeks
c) 500-1000 mg/m2 every 2-3 weeks
d) 1500-2000 mg/m2 every 4-6 weeks
Answer: C. The usual dose of cyclophosphamide for cancer treatment is
500-1000 mg/m2 given intravenously every 2-3 weeks, depending on the
type and stage of cancer, the patient's response and tolerance, and the
combination with other anticancer drugs.
Rationale: A, B and D are either too low or too high doses of
cyclophosphamide for cancer treatment.
5. What are the contraindications for cyclophosphamide use?
a) Pregnancy, lactation and hypersensitivity
b) Renal impairment, hepatic impairment and infection
c) Diabetes mellitus, hypertension and peptic ulcer disease
d) All of the above
Answer: D. Cyclophosphamide is contraindicated in patients who are
pregnant or lactating, as it can cause fetal harm or pass into breast milk. It
is also contraindicated in patients who have hypersensitivity to
cyclophosphamide or any of its components. Cyclophosphamide should
be used with caution in patients who have renal impairment, hepatic
impairment or infection, as it can worsen these conditions or increase the
risk of complications.
Rationale: C is not a contraindication for cyclophosphamide use, but
rather a comorbidity that may require dose adjustment or monitoring.
6. What are the drug interactions of cyclophosphamide?
a) It increases the effects of anticoagulants, such as warfarin
b) It decreases the effects of immunosuppressants, such as cyclosporine
c) It enhances the toxicity of other anticancer drugs, such as doxorubicin
d) All of the above
Answer: D. Cyclophosphamide can interact with several drugs that affect
