CH-21 Chemotherapy Drugs – Understanding Pharmacology for Health Professionals : Exam Guide

Chapter 21: Chemotherapy Drugs Multiple Choice Questions 1. Which of the following is NOT one of the three categories of antimetabolite chemotherapy drugs? a. folic acid blocker chemotherapy drugs b. nitrosourea chemotherapy drugs c. purine analog chemotherapy drugs d. pyrimidine analog chemotherapy drugs Answer: b. nitrosourea chemotherapy drugs Correct Feedback: Antimetabolite chemotherapy drugs include purine analog chemotherapy drugs, pyrimidine analog chemotherapy drugs, and folic acid blocker chemotherapy drugs. Nitrosourea chemotherapy drugs are alkylating chemotherapy drugs. a. folic acid blocker chemotherapy drugs Incorrect Feedback: Folic acid blocker chemotherapy drugs are a category of antimetabolite chemotherapy drugs. c. purine analog chemotherapy drugs Incorrect Feedback: Purine analog chemotherapy drugs are a category of antimetabolite chemotherapy drugs. d. pyrimidine analog chemotherapy drugs Incorrect Feedback: Pyrimidine analog chemotherapy drugs are a category of antimetabolite chemotherapy drugs. 2. To kill cancer cells, alkylating chemotherapy drugs cause alkylation, a chemical reaction in which an alkyl group ______. a. allows microtubules to form but not function properly b. binds to antigens on the surface of cancer cells c. is substituted for a hydrogen molecule in the DNA or RNA of the cancer cell d. inhibits the release of hormones to create an environment where cancer cells cannot grow Answer: c. is substituted for a hydrogen molecule in the DNA or RNA of the cancer cell Correct Feedback: Alkylating chemotherapy drugs cause alkylation, a chemical reaction in which an alkyl group from the chemotherapy drug is substituted for a hydrogen molecule in DNA and/or RNA. This causes abnormal cross-linking in the DNA strands, and the cancer cell cannot divide. a. allows microtubules to form but not function properly Incorrect Feedback: Alkylating chemotherapy drugs do not affect microtubules. b. binds to antigens on the surface of cancer cells Incorrect Feedback: Alkylating chemotherapy drugs do not bind to antigens on the surface of cancer cells. d. inhibits the release of hormones to create an environment where cancer cells cannot grow Incorrect Feedback: Alkylating chemotherapy drugs do not affect the hormonal environment. 3. Nitrosourea chemotherapy drugs insert an alkyl group into the cancer cell’s ______. a. DNA only b. RNA only c. DNA and RNA. d. cell membrane Answer: c. DNA and RNA. Correct Feedback: Nitrosourea chemotherapy drugs insert an alkyl group into both DNA and RNA. a. DNA only Incorrect Feedback: Nitrosourea chemotherapy drugs do not insert an alkyl group into just the DNA. b. RNA only Incorrect Feedback: Nitrosourea chemotherapy drugs do not insert an alkyl group into just the RNA. d. cell membrane Incorrect Feedback: Nitrosourea chemotherapy drugs do not insert an alkyl group into the cell membrane. 4. Androgen hormonal chemotherapy drugs are used to treat ______. a. breast cancer in females b. Hodgkin’s lymphoma in both men and women c. leukemia in both men and women d. testicular cancer in men Answer: a. breast cancer in females Correct Feedback: Androgen hormonal chemotherapy drugs are used to treat breast cancer in females because they create a male sex hormone environment, which is the opposite from what the breast cancer cells need to grow. b. Hodgkin’s lymphoma in both men and women Incorrect Feedback: Androgen hormonal chemotherapy drugs are not used to treat Hodgkin’s lymphoma. c. leukemia in both men and women Incorrect Feedback: Androgen hormonal chemotherapy drugs are not used to treat leukemia. d. testicular cancer in men Incorrect Feedback: Androgen hormonal chemotherapy is not used to treat testicular cancer. 5. Gonadotropin-releasing hormone chemotherapy drugs compete with GnRH and block GnRH receptors in the anterior pituitary gland, so that the anterior pituitary gland does not secrete ______. a. estradiol b. luteinizing hormone c. progesterone d. testosterone Answer: b. luteinizing hormone Correct Feedback: Gonadotropin-releasing hormone (GnRH) is produced by the hypothalamus, and its action causes the anterior pituitary gland to secrete luteinizing hormone. a. estradiol Incorrect Feedback: The anterior pituitary gland does not secrete estradiol. c. progesterone Incorrect Feedback: The anterior pituitary gland does not secrete progesterone. d. testosterone Incorrect Feedback: The anterior pituitary gland does not secrete testosterone. 6. Chemotherapy enzyme drugs are used to treat ______. a. breast cancer in females b. all types of cancer c. leukemia in both men and women d. testicular cancer in men Answer: c. leukemia in both men and women Correct Feedback: Chemotherapy enzyme drugs break down the amino acid asparagines. Leukemia cells cannot synthesize their own asparagines. By breaking down asparagines, the cancer cell cannot use it to build protein and cannot divide. Chemotherapy enzyme drugs are used to treat leukemia. a. breast cancer in females Incorrect Feedback: Chemotherapy enzyme drugs are not used to treat breast cancer. b. all types of cancer Incorrect Feedback: Chemotherapy enzyme drugs are not used to treat all types of cancer. d. testicular cancer in men Incorrect Feedback: Chemotherapy enzyme drugs are not used to treat testicular cancer. 7. Antiandrogen hormonal chemotherapy drugs bind to and block receptors in ______. a. breast tissue b. liver tissue c. lung tissue d. prostate gland tissue Answer: d. prostate gland tissue Correct Feedback: Antiandrogen hormonal chemotherapy drugs bind to and block receptors in prostate gland tissue that are normally stimulated by testosterone. a. breast tissue Incorrect Feedback: Antiandrogen hormonal chemotherapy drugs do not block receptors in breast tissue. b. liver tissue Incorrect Feedback: Antiandrogen hormonal chemotherapy drugs do not block receptors in liver tissue. c. lung tissue Incorrect Feedback: Antiandrogen hormonal chemotherapy drugs do not block receptors in lung tissue. 8. Which of the following is NOT a type of mitosis inhibitor chemotherapy drug? a. podophyllotoxin chemotherapy drugs b. protein-tyrosine kinase inhibitor chemotherapy drugs c. topoisomerase chemotherapy drugs d. vinca alkaloid chemotherapy drugs Answer: b. protein-tyrosine kinase inhibitor chemotherapy drugs Correct Feedback: The category of mitosis inhibitor chemotherapy drugs includes podophyllotoxin chemotherapy drugs, topoisomerase chemotherapy drugs, taxane chemotherapy drugs, vinca alkaloid chemotherapy drugs, and other mitosis inhibitor chemotherapy drugs. a. podophyllotoxin chemotherapy drugs Incorrect Feedback: Podophyllotoxin chemotherapy drugs are a type of mitosis chemotherapy drug. c. topoisomerase chemotherapy drugs Incorrect Feedback: Topoisomerase chemotherapy drugs are a type of mitosis chemotherapy drug. d. vinca alkaloid chemotherapy drugs Incorrect Feedback: Vinca alkaloid chemotherapy drugs are a type of mitosis chemotherapy drug. 9. Platinum chemotherapy drugs contain the precious metal platinum that _______. a. binds to tubulin in the microtubules b. changes folic acid into a metabolite c. creates cross-links in DNA strands d. interferes with cellular metabolism Answer: c. creates cross-links in DNA strands Correct Feedback: Platinum chemotherapy drugs create cross-links in DNA strands, and the cancer cell cannot divide. a. binds to tubulin in the microtubules Incorrect Feedback: Platinum chemotherapy drugs do not bind to tubulin in the microtubules. b. changes folic acid into a metabolite Incorrect Feedback: Platinum chemotherapy drugs do not change folic acid into a metabolite. d. interferes with cellular metabolism Incorrect Feedback: Platinum chemotherapy drugs do not interfere with cellular metabolism. 10. Which chemotherapy drug is structurally related to vitamin A? a. Interferon chemotherapy drugs b. Interleukin chemotherapy drugs c. Monoclonal antibody drugs d. Retinoid chemotherapy drugs Answer: d. Retinoid chemotherapy drugs Correct Feedback: Retinoid chemotherapy drugs are structurally related to vitamin A (retinoic acid). a. Interferon chemotherapy drugs Incorrect Feedback: Interferon chemotherapy drugs are not structurally related to vitamin A. b. Interleukin chemotherapy drugs Incorrect Feedback: Interleukin chemotherapy drugs are not structurally relate to vitamin A. c. Monoclonal antibody drugs Incorrect Feedback: Monoclonal antibody drugs are not structurally related to vitamin A. 11. Which of these drugs is created using recombinant DNA technology? a. Interferon chemotherapy drugs b. Monoclonal antibody chemotherapy drugs c. Both interferon chemotherapy drugs and monoclonal antibody chemotherapy drugs d. Retinoid chemotherapy drugs. Answer: c. Both interferon chemotherapy drugs and monoclonal antibody chemotherapy drugs Correct Feedback: Interferon chemotherapy drugs are manufactured by recombinant DNA technology and are used to treat many different types of viral diseases and cancer. Monoclonal antibody (MAb) drugs are created using recombinant DNA technology. a. Interferon chemotherapy drugs Incorrect Feedback: Interferon chemotherapy drugs are created using recombinant DNA technology, but they are not the only ones. b. Monoclonal antibody chemotherapy drugs Incorrect Feedback: Monoclonal antibody chemotherapy drugs are created using recombinant DNA technology, but they are not the only ones. d. Retinoid chemotherapy drugs. Incorrect Feedback: Retinoid chemotherapy drugs are not created using recombinant DNA technology. 12. Immunomodulator chemotherapy drugs modulate or regulate _______. a. antigens involved in the differentiation of cells b. DNA and/or RNA c. receptors on the cell wall of cancer cells d. the immune system Answer: d. the immune system Correct Feedback: Immunomodulator chemotherapy drugs modulate or regulate the immune system. a. antigens involved in the differentiation of cells Incorrect Feedback: Immunomodulator chemotherapy drugs do not regulate antigens. b. DNA and/or RNA Incorrect Feedback: Immunomodulator chemotherapy drugs do not regulate DNA and/or RNA. c. receptors on the cell wall of cancer cells Incorrect Feedback: Immunomodulator drugs do not regulate receptors. 13. The selection of an appropriate chemotherapy drug is based on ______. a. the type of cancer b. the stage of the cancer c. the type of cancer and the stage of the cancer d. where the cancer is located Answer: c. the type of cancer and the stage of the cancer Correct Feedback: The selection of an appropriate chemotherapy drug is based on the type of cancer and the stage of cancer. a. the type of cancer Incorrect Feedback: This is true, but it is not the only correct answer. b. the stage of the cancer Incorrect Feedback: This is true, but it is not the only correct answer. d. where the cancer is located Incorrect Feedback: The selection of an appropriate chemotherapy drug is not based on the location of the cancer. 14. Antimetabolite chemotherapy drugs act against metabolites, which are important byproducts produced from other substances in the cell during the process of ______. a. cell death b. cell division c. DNA or RNA replication d. metabolism Answer: d. metabolism Correct Feedback: Antimetabolite chemotherapy drugs act against metabolites, important byproducts produced from other substances in the cell during the process of metabolism. a. cell death Incorrect Feedback: Metabolites are not produced during cell death. b. cell division Incorrect Feedback: Metabolites are not produced during cell division. c. DNA or RNA replication Incorrect Feedback: Metabolites are not produced during DNA or RNA replication. 15. Which of the following suffixes is NOT common to generic gonadotropin-releasing hormone chemotherapy drugs? a. –tropin b. –lide c. –relin d. –relix Answer: a. –tropin Correct Feedback: The suffixes –lide, –relin, and –relix are common to generic gonadotropin-releasing hormone chemotherapy drugs. b. –lide Incorrect Feedback: The suffix –lide is common to generic gonadotropinreleasing hormone chemotherapy drugs. c. –relin Incorrect Feedback: The suffix –relin is common to generic gonadotropinreleasing hormone chemotherapy drugs. d. –relix Incorrect Feedback: The suffix –relix is common to generic gonadotropinreleasing hormone chemotherapy drugs. 16. In order to treat cancer, the physician must ______. a. diagnose the type of cancer b. determine the stage of the cancer c. wait for a remission d. a and b Answer: d. a and b Correct Feedback: To properly treat any type of cancer, the physician must determine two things: the type of cancer and the stage of the cancer. a. diagnose the type of cancer Incorrect Feedback: This is true, but it is not the only correct answer. b. determine the stage of the cancer Incorrect Feedback: This is true, but it is not the only correct answer. c. wait for a remission Incorrect Feedback: This is not a true statement. 17. The first chemotherapy drug was ______. a. nitrogen mustard b. methotrexate c. cisplatin d. interferon Answer: a. nitrogen mustard Correct Feedback: The discovery of the first chemotherapy drug, nitrogen mustard, came about serendipitously. b. methotrexate Incorrect Feedback: Methotrexate was not the first chemotherapy drug. c. cisplatin Incorrect Feedback: Cisplatin was not the first chemotherapy drug. d. interferon Incorrect Feedback: Interferon was not the first chemotherapy drug. 18. Antimetabolite chemotherapy drugs include all of the following EXCEPT ______. a. drugs take the place of purine that the cancer cell needs to divide Incorrect Feedback: Antimetabolite chemotherapy drugs do this. b. drugs that bind to antigens on the surface of cancer cells Correct Feedback: Monoclonal antibody drugs selectively bind to specific antigens on the surface of cancer cells. c. drugs that prevent the formation of folic acid that the cancer cell needs Incorrect Feedback: Antimetabolite chemotherapy drugs do this. d. drugs that take the place of pyrimidine so the cancer cell cannot build DNA Incorrect Feedback: Antimetabolite chemotherapy drugs do this. Answer: b. drugs that bind to antigens on the surface of cancer cells Correct Feedback: Estrogen hormonal chemotherapy drugs include conjugated estrogens (Premarin). a. drugs take the place of purine that the cancer cell needs to divide Incorrect Feedback: Antimetabolite chemotherapy drugs do this. c. drugs that prevent the formation of folic acid that the cancer cell needs Incorrect Feedback: Antimetabolite chemotherapy drugs do this. d. drugs that take the place of pyrimidine so the cancer cell cannot build DNA Incorrect Feedback: Antimetabolite chemotherapy drugs do this. 19. All of the following are examples of chemotherapy antibiotic drugs EXCEPT ______. a. conjugated estrogens (Premarin) b. bleomycin (Blenoxane) c. doxorubicin (Adriamycin) d. dactinomycin (Cosmegen) Answer: a. conjugated estrogens (Premarin) Correct Feedback: Estrogen hormonal chemotherapy drugs include conjugated estrogens (Premarin). b. bleomycin (Blenoxane) Incorrect Feedback: Bleomycin (Blenoxane) is a chemotherapy antibiotic drug. c. doxorubicin (Adriamycin) Incorrect Feedback: Doxorubicin (Adriamycin) is a chemotherapy antibiotic drug. d. dactinomycin (Cosmegen) Incorrect Feedback: Dactinomycin (Cosmegen) is a chemotherapy antibiotic drug. 20. The drug epoetin alfa (Epogen, Procrit) is used to stimulate the production of ______ in patients with cancer. a. white blood cells b. interferon c. nitrogen mustard d. red blood cells Answer: d. red blood cells Correct Feedback: Epoetin alfa (Epogen, Procrit) is used to stimulate red blood cell production to treat anemia caused by the cancer itself or by the treatment of chemotherapy drugs or radiation therapy. a. white blood cells Incorrect Feedback: Epoetin alfa does not stimulate the production of white blood cells. b. interferon Incorrect Feedback: Epoetin alfa does not stimulate the production of interferon. c. nitrogen mustard Incorrect Feedback: Epoetin alfa does not stimulate the production of nitrogen mustard. 21. Select the statement that is FALSE. a. Chemotherapy drugs often cause nausea and vomiting. b. Nitrogen mustard was first used in chemical warfare. c. Some chemotherapy drugs come from the periwinkle plant. d. Interferon is released when the cell is invaded by cancer. Answer: d. Interferon is released when the cell is invaded by cancer. Correct Feedback: Interferon is an immunomodulator chemical that is released by a cell when it is invaded by a virus. a. Chemotherapy drugs often cause nausea and vomiting. Incorrect Feedback: This is a true statement. b. Nitrogen mustard was first used in chemical warfare. Incorrect Feedback: This is a true statement. c. Some chemotherapy drugs come from the periwinkle plant. Incorrect Feedback: This is a true statement. 22. Select the statement that is FALSE. a. Chemotherapy protocols are designated by acronyms. b. A remission occurs when cancer cells stop reproducing. c. Corticosteroids are a chemotherapy drugs. d. Certain cancers come from tissues that are influenced by male or female hormones. Answer: c. Corticosteroids are a chemotherapy drugs. Correct Feedback: Corticosteroids drugs are given to decrease the tissue inflammation caused by chemotherapy drugs. a. Chemotherapy protocols are designated by acronyms. Incorrect Feedback: This is a true statement. b. A remission occurs when cancer cells stop reproducing. Incorrect Feedback: This is a true statement. d. Certain cancers come from tissues that are influenced by male or female hormones. Incorrect Feedback: This is a true statement. 23. All of the following are categories of hormonal chemotherapy drugs EXCEPT ______. a. aromatase inhibitor b. antiandrogen c. progestin d. demethylating Answer: d. demethylating Correct Feedback: Demethylating chemotherapy drugs inhibit the enzyme methyltransferase. They are not hormonal chemotherapy drugs. a. aromatase inhibitor Incorrect Feedback: Aromatase inhibitor hormonal chemotherapy drugs are one of these categories. b. antiandrogen Incorrect Feedback: Antiandrogen hormonal chemotherapy drugs are one of these categories. c. progestin Incorrect Feedback: Progestin hormonal chemotherapy drugs are one of these categories. 24. Which of the following statements is FALSE? a. The stage of the cancer indicates whether the cancer has spread beyond the original or primary site and metastasized to secondary sites. b. Uncontrolled cell division and metastasis are identifying characteristics of cancer cells. c. Benign and malignant neoplasms are classified as cancer. d. A treatment that is appropriate for one type of cancer is usually not appropriate for a different type of cancer. Answer: c. Benign and malignant neoplasms are classified as cancer. Correct Feedback: All malignant neoplasms are classified as cancer. a. The stage of the cancer indicates whether the cancer has spread beyond the original or primary site and metastasized to secondary sites. Incorrect Feedback: This is a true statement. b. Uncontrolled cell division and metastasis are identifying characteristics of cancer cells. Incorrect Feedback: This is a true statement. d. A treatment that is appropriate for one type of cancer is usually not appropriate for a different type of cancer. Incorrect Feedback: This is a true statement. 25. Adjuvant therapy _________. a. can include chemotherapy or radiation therapy b. helps to eradicate any remaining tumor cells c. is given after surgery to remove a tumor d. all of the above Answer: d. all of the above Correct Feedback: Adjuvant therapy refers to chemotherapy (or radiation therapy) that is given to cancer patients after they have had surgery to remove a tumor. The purpose of adjuvant therapy is to aid in eradicating any remaining tumor cells. a. can include chemotherapy or radiation therapy Incorrect Feedback: This is true, but it is not the only correct answer. b. helps to eradicate any remaining tumor cells Incorrect Feedback: This is true, but it is not the only correct answer. c. is given after surgery to remove a tumor Incorrect Feedback: This is true, but it is not the only correct answer. 26. Which of the following statements is FALSE? a. A remission occurs when cancer cells stop actively dividing. b. All patients have a complete remission following chemotherapy. c. If the patient fails chemotherapy, it means that the tumor increased while on chemotherapy. d. If a patient fails chemotherapy, the physician will try a new combination of chemotherapy drugs. Answer: b. All patients have a complete remission following chemotherapy. Correct Feedback: Some cancer patients experience a complete remission following chemotherapy, others have a partial remission, but some patients actually experience tumor growth while being treated with chemotherapy. a. A remission occurs when cancer cells stop actively dividing. Incorrect Feedback: This is a true statement. c. If the patient fails chemotherapy, it means that the tumor increased while on chemotherapy. Incorrect Feedback: This is a true statement. d. If a patient fails chemotherapy, the physician will try a new combination of chemotherapy drugs. Incorrect Feedback: This is a true statement. 27. The category of antimetabolite chemotherapy drugs includes all of the following types of drugs EXCEPT _____. a. folic acid blocker chemotherapy drugs b. nitrosourea chemotherapy drugs c. purine analog chemotherapy drugs d. pyrimidine analog chemotherapy drugs Answer: b. nitrosourea chemotherapy drugs Correct Feedback: The category of antimetabolite chemotherapy drugs includes purine analog chemotherapy drugs, pyrimidine analog chemotherapy drugs, and folic acid blocker chemotherapy drugs. Nitrosourea chemotherapy drugs belong to the category of alkylating chemotherapy drugs. a. folic acid blocker chemotherapy drugs Incorrect Feedback: Antimetabolite chemotherapy drugs do include folic acid blocker chemotherapy drugs. c. purine analog chemotherapy drugs Incorrect Feedback: Antimetabolite chemotherapy drugs do include purine analog chemotherapy drugs. d. pyrimidine analog chemotherapy drugs Incorrect Feedback: Antimetabolite chemotherapy drugs do include pyrimidine analog chemotherapy drugs. 28. _____ is a molecule that forms the base upon which adenine and guanine are built (two important components of the DNA molecule.) a. Interleukin b. Metabolite c. Corticosteroid d. Purine Answer: d. Purine Correct Feedback: Purine is a molecule that forms the base upon which adenine and guanine are built. These two substances are important components of the DNA molecule in each cell. a. Interleukin Incorrect Feedback: Interleukin does not form the base for adenine and guanine. b. Metabolite Incorrect Feedback: Metabolite does not form the base for adenine and guanine. c. Corticosteroid Incorrect Feedback: Corticosteroid does not form the base for adenine and guanine. 29. Which of the following is a pyrimidine analog chemotherapy drug? a. capecitabine (Xeloda) b. mechlorethamine (Mustargen) c. doxorubicin (Adriamycin) d. testosterone (Delatestryl) Answer: a. capecitabine (Xeloda) Correct Feedback: Pyrimidine analog chemotherapy drugs inlcude capecitabine (Xeloda). b. mechlorethamine (Mustargen) Incorrect Feedback: Mechlorethamine (Mustargen) is not a pyrimidine analog chemotherapy drug. c. doxorubicin (Adriamycin) Incorrect Feedback: Doxorubicin (Adriamycin) is not a pyrimidine analog chemotherapy drug. d. testosterone (Delatestryl) Incorrect Feedback: Testosterone (Delatestryl) is not a pyrimidine analog chemotherapy drug. 30. All of the following are nitrosourea chemotherapy drugs EXCEPT _____. a. carmustine (BiCNU) b. lomustine (CeeNU) c. streptozocin (Zanosar) d. mitomycin (Mutamycin) Answer: d. mitomycin (Mutamycin) Correct Feedback: Mitomycin (Mutamycin) is a chemotherapy antibiotic drug. a. carmustine (BiCNU) Incorrect Feedback: Carmustine (BiCNU) is a nitrosourea chemotherapy drug. b. lomustine (CeeNU) Incorrect Feedback: Lomustine (CeeNU) is a nitrosourea chemotherapy drug. c. streptozocin (Zanosar) Incorrect Feedback: Streptozocin (Zanosar) is a nitrosourea chemotherapy drug. 31. All of the following drugs belong to the category of hormonal chemotherapy drugs EXCEPT _____. a. estrogen chemotherapy drugs b. androgen chemotherapy drugs c. aromatase inhibitor chemotherapy drugs d. podophyllotoxin chemotherapy drugs Answer: d. podophyllotoxin chemotherapy drugs Correct Feedback: The category of hormonal chemotherapy drugs includes androgen hormonal chemotherapy drugs, antiandrogen hormonal chemotherapy drugs, estrogen hormonal chemotherapy drugs, antiestrogen hormonal chemotherapy drugs, progestin hormonal chemotherapy drugs, gonadotropinreleasing hormone chemotherapy drugs, aromatase inhibitor hormonal chemotherapy drugs, and other hormonal chemotherapy drugs. Podophyllotoxin chemotherapy drugs belong to the category of mitosis inhibitor chemotherapy drugs. a. estrogen chemotherapy drugs Incorrect Feedback: Estrogen hormonal chemotherapy drugs do belong to the category of hormonal chemotherapy drugs. b. androgen chemotherapy drugs Incorrect Feedback: Androgen hormonal chemotherapy drugs do belong to the category of hormonal chemotherapy drugs. c. aromatase inhibitor chemotherapy drugs Incorrect Feedback: Aromatase inhibitor hormonal chemotherapy drugs do belong to the category of hormonal chemotherapy drugs. 32. Some cancers have receptors on the surface of their cells that are stimulated by _____. a. radiation b. mitosis c. hormones d. microtubules Answer: c. hormones Correct Feedback: Certain cancers that need hormones to grow have receptors on the surface of their cells for those hormones, and the growth of these cancers is stimulated by those hormones. a. radiation Incorrect Feedback: Cancer cell receptors are not stimulated by radiation. b. mitosis Incorrect Feedback: Mitosis is the process of cell division, not a type of receptor. d. microtubules Incorrect Feedback: Microtubules occur during cell division; they are not a type of receptor. 33. Which of the following is NOT a trade name progestin hormonal chemotherapy drug? a. Evista b. Depo-Provera c. Megace d. Provera Answer: a. Evista Correct Feedback: Raloxifene (Evista) is an estrogen hormonal chemotherapy drug. b. Depo-Provera Incorrect Feedback: Depo-Provera is a progestin hormonal chemotherapy drug. c. Megace Incorrect Feedback: Megace is a progestin hormonal chemotherapy drug. d. Provera Incorrect Feedback: Provera is a progestin hormonal chemotherapy drug. 34. Podophyllotoxin chemotherapy drugs are derived from ______. a. the soil b. mayapple plant c. folic acid d. a drug used for chemical warfare Answer: b. mayapple plant Correct Feedback: Podophyllotoxin chemotherapy drugs are semisynthetic drugs created from a toxin found in the fleshy root of the mayapple, whose scientific name is Podophyllum peltatum. a. the soil Incorrect Feedback: Podophyllotoxin chemotherapy drugs are not derived from the soil. c. folic acid Incorrect Feedback: Podophyllotoxin chemotherapy drugs are not derived from folic acid. d. a drug used for chemical warfare Incorrect Feedback: Podophyllotoxin chemotherapy drugs are not derived from a drug used for chemical warfare. 35. Vinca alkaloid chemotherapy drugs _____. a. bind to tubulin in the microtubules b. are derived from the periwinkle plant c. are used to treat many different kinds of cancer d. all of the above Answer: d. all of the above Correct Feedback: Vinca alkaloid chemotherapy drugs interfere with the production of DNA and RNA and also interfere with cellular metabolism and the production of the energy need to complete cell division. They also bind to tubulin in the microtubules, and the cancer cell cannot divide. These drugs are used to treat many different types of cancer. a. bind to tubulin in the microtubules Incorrect Feedback: This is true, but it is not the only correct answer. b. are derived from the periwinkle plant Incorrect Feedback: This is true, but it is not the only correct answer. c. are used to treat many different kinds of cancer Incorrect Feedback: This is true, but it is not the only correct answer. 36. Which of the following statements is FALSE? a. Platinum is a precious metal that is mostly mined in South Africa. b. Interleukin is released when a cell is invaded by a virus. c. Chemotherapy enzyme drugs are enzymes that break down the amino acid asparagine. d. There are vitamin A receptors on cancer cells and retinoid chemotherapy drugs bind to them. Answer: b. Interleukin is released when a cell is invaded by a virus. Correct Feedback: Interleukins are proteins that are secreted by white blood cells when they encounter bacteria or antigens. a. Platinum is a precious metal that is mostly mined in South Africa. Incorrect Feedback: This is a true statement c. Chemotherapy enzyme drugs are enzymes that break down the amino acid asparagine. Incorrect Feedback: This is a true statement. d. There are vitamin A receptors on cancer cells and retinoid chemotherapy drugs bind to them. Incorrect Feedback: This is a true statement. 37. Epidermal growth factor receptor inhibitor chemotherapy drugs block epidermal growth factor and so the cancer cell cannot _____. a. spread through the body b. divide c. grow d. all of the above Answer: c. grow Correct Feedback: Without epidermal growth factor stimulating the receptor, the cancer cell cannot grow. a. spread through the body Incorrect Feedback: This is not correct. b. divide Incorrect Feedback: This is not correct. d. all of the above Incorrect Feedback: Only one of the answers is correct. 38. Purine is a molecule that forms the base upon which cytosine, thymine, and uracil are built as part of the DNA molecule. Answer: False Feedback: Pyrimidine is a molecule that forms the base upon which cytosine, thymine, and uracil are built. These three substances are important components of the DNA molecule. 39. Folic acid blocker chemotherapy drugs act as an antagonist in that they complete with folic acid for the same enzyme. Answer: True Feedback: Folic acid blocker drugs act as antagonists in that they compete with folic acid for the same enzyme. 40. Cancers that arise from tissue that is influenced by a sex hormone are treated with a chemotherapy drug that blocks the effect of that hormone and surrounds the cancer cells with a hormone that has the opposite hormonal effect. Answer: True Feedback: Chemotherapy drugs used to treat these cancers block the effect of those hormones or surround the cancer cells with a hormone that has the opposite hormonal effect. 41. Mitosis inhibitor drugs affect dividing cells and keep them from completing the process of cell division. Answer: True Feedback: Mitosis inhibitor drugs affect dividing cells and keep them from completing the process of cell division. 42. Antiestrogen hormonal chemotherapy drugs are used to treat breast cancer because they stimulate estradiol receptors in breast tissue. Answer: False Feedback: Antiestrogen hormonal chemotherapy drugs bind to and block receptors in breast tissue that are normally stimulated by estradiol. 43. Epidermal growth factor receptor inhibitor drugs work on cancer cells because more epidermal growth receptors are found on cancer cells than on normal cells. Answer: True Feedback: Receptors for epidermal growth factor are found on the cell surfaces of normal cells, but more receptors are found on cancer cells, which is why they grow rapidly. 44. Corticosteroid drugs are given to decrease the tissue inflammation caused by chemotherapy drugs. Answer: True Feedback: Corticosteroids drugs are given to decrease the tissue inflammation caused by chemotherapy drugs. 45. Interleukin chemotherapy drugs are only used to treat leukemia. Answer: False Feedback: Interleukin chemotherapy drugs are used to treat many different types of cancer. 46. Monoclonal antibody drugs selectively bind to specific antigens on the surface of cancer cell walls. Answer: True Feedback: Monoclonal antibody drugs selectively bind to specific antigens on the surface of cancer cell walls. 47. Like flu vaccines, cancer vaccines are given before the patient has contracted cancer to help prevent cancer from developing. Answer: False Feedback: Unlike flu vaccines that are given prior to the flu season to prevent patients from getting influenza, cancer vaccines are given after the patient has cancer. 48. Nitrosourea chemotherapy drugs not only insert an alkyl group in both the DNA and RNA of a cancer cell, but also inhibit enzymes within the cell. Answer: True Feedback: Nitrosourea chemotherapy drugs insert an alkyl group into both DNA and RNA. DNA and RNA cannot be produced and the cancer cell cannot divide. These drugs also inhibit enzymes within the cell. 49. The suffix –platin is common to platinum chemotherapy drugs. Answer: True Feedback: The suffix –platin is common to generic platinum chemotherapy drugs. 50. Chemotherapy drugs target rapidly dividing cancer cells. However, their effects are also felt in other areas where cells normally divide rapidly, such as in the mucous membranes lining the mouth and intestines and in the bone marrow. Answer: True Feedback: Chemotherapy drugs target rapidly dividing cancer cells. However, their effects are also felt in other areas where cells normally divide rapidly, such as in the mucous membranes lining the mouth and intestines and in the bone marrow. 51. Purine analog chemotherapy drugs are used to treat different types of leukemia. Answer: True Feedback: Purine analog chemotherapy drugs are used to treat different types of leukemia. 52. The pyrimidine analog chemotherapy drug cytarabine was developed from a substance found in Caribbean sea sponges. Answer: True Feedback: The pyrimidine analog chemotherapy drug cytarabine was developed from a substance found in Caribbean sea sponges. 53. Corticosteroid drugs are used to treat anemia caused by chemotherapy drugs. Answer: True Feedback: Corticosteroid drugs are also used to treat the anemia caused by chemotherapy drugs. 54. A cancer vaccine targets a specific type of cancer by including in the vaccine a fragment of protein that is unique to that type of cancer. Answer: True Feedback: A cancer vaccine targets a specific type of cancer by including in the vaccine a fragment of protein that is unique to that type of cancer. 55. Chemotherapy antibiotic drugs are also used to treat some types of bacterial infections. Answer: False Feedback: Chemotherapy antibiotic drugs are not interchangeable with regular antibiotic drugs. Regular antibiotic drugs that are used to treat infection act on the cell walls of bacteria. 56. Leucovorin rescue occurs before methotrexate chemotherapy. Answer: False Feedback: Administration of leucovorin after methotrexate chemotherapy is known as leucovorin rescue because the drug rescues the patient from the toxic effects of methotrexate. 57. According to the FDA, the generic name of a chemotherapy drug that is used during clinical trials must be the same generic name that is then approved for marketing. Answer: False Feedback: Some chemotherapy drugs have older drug names that were used during clinical trials before the generic and trade name drugs were marketed. 58. The extent of cancer progression is referred to as the stage. True Answer: True Feedback: The extent of cancer progression is referred to as the stage. 59. Chemotherapy drugs are included on lists of known human carcinogens. Answer: True Feedback: Chemotherapy drugs are included on lists of known human carcinogens. 60. Drugs used to treat cancers or malignant neoplasms are known as chemotherapy drugs or __________ drugs. Answer: antineoplastic Feedback: Drugs used to treat cancers or malignant neoplasms are known as chemotherapy drugs or antineoplastic drugs. 61. A/an __________ is a drug that is created by slightly modifying the molecular structure of another substance. Answer: analog Feedback: An analog is a drug that is created by slightly modifying the molecular structure of another substance. 62. The suffix __________ is common to antiandrogen hormonal chemotherapy drugs. Answer: –lutamide Feedback: The suffix –lutamide is common to antiandrogen hormonal chemotherapy drugs. 63. Estrogen hormonal chemotherapy drugs are used to provide __________ treatment for advanced breast cancer and/or advanced prostatic cancer; this is a treatment that provides relief from symptoms but is not intended to cure. Answer: palliative Feedback: Estrogen hormonal chemotherapy drugs are used to provide palliative treatment for advanced breast cancer and/or advanced prostatic cancer. Palliative treatment provides relief from symptoms but is not intended to cure. 64. A neoplasm is a new growth of cells that may be ______ or malignant. Answer: benign Feedback: A neoplasm is a new growth of cells that may be benign or malignant. 65. When a patient receives a chemotherapy drug that is known to be toxic to a particular organ, the patient is also given a drug to protect that organ from toxicity. This drug exerts a ______ effect. Answer: cytoprotective Feedback: When a patient receives a chemotherapy drug that is known to be toxic to a particular organ, the patient is also given a drug to protect that organ from toxicity. These drugs exert a cytoprotective effect 66. Mesna protects the ______ from toxicity due to the chemotherapy drug ifosfamide. Answer: bladder Feedback: Mesna protects the bladder from toxicity due to ifosfamide. 67. Estrogen hormone drugs act in a similar way to the main female hormone _____, which is produced by follicles of the ovary. Answer: estradiol Feedback: Estrogen hormone drugs act in a similar way to the main female hormone estradiol, which is produced by follicles of the ovary. 68. Folic acid is a _____ vitamin whose metabolite is important in DNA production in the cell. Answer: B Feedback: Folic acid is a B vitamin whose metabolite is important in DNA production in the cell. 69. To determine the type of cancer, a _____ is taken from the tumor site or a blood specimen is drawn to examine blood cells. Answer: biopsy Feedback: To determine the type of cancer, a biopsy is taken from the tumor site or a blood specimen is drawn to examine blood cells. 70. Thyrotropin alfa (Thyrogen) is a hormonal chemotherapy drug that is used to treat _____ cancer. Answer: thyroid Feedback: Thyrotropin alfa is derived from thyroid-stimulating hormone (which is produced by the anterior pituitary gland). Thyrotropin alfa is used to treat thyroid cancer. 71. The generic drugs vinblastine, vincristine, and vinorelbine all belong to the category of _______ chemotherapy drugs. Answer: vinca alkaloid Feedback: Vinca alkaloid drugs include vinblastine, vincristine, and vinorelbine. 72. Topoisomerase is a/an _____ that creates a break in a single strand of DNA to relieve stress during cell division. Answer: enzyme Feedback: Topoisomerase inhibitor chemotherapy drugs affect the enzyme topoisomerase. This enzyme normally relieves the twisting stress on the spiral strands of DNA by creating a break in a single strand so that the strands can separate and be copied during cell division. 73. Docetaxel (Taxotere) belongs to the category of _____ chemotherapy drugs. Answer: taxane Feedback: Taxane chemotherapy drugs include docetaxel (Taxotere). 74. Interferon is an immunomodulator chemical that is released by a cell when it is invaded by a ______. Answer: virus Feedback: Interferon is an immunomodulator chemical that is released by a cell when it is invaded by a virus. 75. The _____ chromosome is an abnormal chromosome that is seen in patients with certain types of leukemia. Answer: Philadelphia Feedback: An abnormal version of the tyrosine kinase enzyme was found to be produced by the Philadelphia chromosome in patients with a certain type of leukemia. 76. 1. aprepitant (Emend) A. antiemetic drug used with chemotherapy 2. capecitabine (Xeloda) B. chemotherapy antibiotic drug 3. doxorubicin (Adriamycin) C. chemotherapy protocol 4. filgrastim (Neupogen) D. corticosteroid drug 5. goserelin (Zoladex) E. granulocyte-colony stimulator factor drug 6. imatinib (Gleevec) F. folic acid blocker chemotherapy drug 7. CHOP G. gonadotropin-releasing hormone chemotherapy drug 8. methotrexate (Trexall) H. protein-tyrosine kinase inhibitor chemotherapy drug 9. paclitaxel (Taxol) I. pyrimidine analog chemotherapy drug 10. prednisone (Deltasone, Meticorten) J. taxane chemotherapy drug Answer: A Answer: I Answer: B Answer: E Answer: G Answer: H Answer: C Answer: F Answer: J Answer: D Feedback: These drugs and their categories are found throughout the chapter. 77. Briefly explain how the effect of most chemotherapy drugs also affects normal cells in the body. Answer: Most chemotherapy drugs exert their action against rapidly dividing cancer cells. However, some normal cells in the body also divide rapidly, such as cells lining the gastrointestinal (GI) tract, hair cells, and blood cells. These normal cells are greatly affected by chemotherapy, with resulting inflammation of the mouth and GI tract, loss of hair, and decreased numbers of red blood cells and white blood cells. 78. Briefly explain how chemotherapy antibiotic drugs are different from regular antibiotic drugs used to treat infections. Answer: Chemotherapy antibiotic drugs are not interchangeable with regular antibiotic drugs. Regular antibiotic drugs that are used to treat infection act on the cell wall of bacteria. Human cells, which do not have a cell wall (they only have a cell membrane), are not affected by antibiotic drugs that treat bacterial infections. However, unlike regular antibiotic drugs, chemotherapy antibiotic drugs do affect human cells. 79. Explain what chemotherapy protocols are and what advantage they offer over a single chemotherapy drug. Answer: Chemotherapy protocols were introduced in the late 1960s in order to combine the effectiveness of several chemotherapy drugs and direct them against one specific type of cancer. Prior to this, only single-agent chemotherapy drugs were used. In selecting drugs for a chemotherapy protocol, the success of each drug in treating that type of cancer is compared with that of other drugs. The most successful drugs are combined into one protocol. The different therapeutic effects of the various chemotherapy drugs maximize the effectiveness of therapy while minimizing the side effects that would be caused by a large dose of just one drug. 80. Give two reasons why some chemotherapy drugs cause the side effects of nausea and vomiting. Answer: Chemotherapy drugs kill rapidly dividing cancer cells, but they also affect the rapidly dividing cells in the mucous membrane of the GI tract, causing irritation. These drugs also directly stimulate the vomiting center in the brain. In addition, some chemotherapy drugs cause the release of serotonin in the small intestine, which stimulates the vomiting reflex. 81. Cancer is a Latin word meaning crab. Explain how cancer resembles a crab. Answer: Cancer is a Latin word meaning crab, because cancer metastasizes or spreads outward from the original site like the legs of a crab. 82. Describe how chemotherapy drugs are prepared in a special sterile environment. Answer: In preparing chemotherapy drugs, pharmacists must maintain sterile technique to protect the immunocompromised cancer patient from infection and also to protect themselves from the toxic effects of exposure to the chemotherapy drug. Working under a laminar flow hood maintains a sterile work environment, as chemotherapy drugs are injected into bags of intravenous fluids. A laminar flow hood constantly takes in the surrounding air, passes it through a HEPA filter to remove all bacteria, and then blows the purified air throughout the work space. This pharmacist is wearing gloves and a gown to maintain a sterile environment, but also to protect her skin and clothing from exposure to the chemotherapy drug. 83. What two things must the physician determine before selecting an appropriate chemotherapy drug treatment regimen? Answer: Only when the type of cancer and its stage has been determined can the physician select an appropriate chemotherapy drug treatment regimen. 84. Briefly explain how the first chemotherapy drug—nitrogen mustard—was discovered. Answer: The discovery of the first chemotherapy drug, nitrogen mustard, came about serendipitously. During the 1940s, researchers who were reviewing medical records from World War I noticed that Allied soldiers who were exposed to the chemical weapon nitrogen mustard gas had a decreased level of white blood cells. It was thought that this adverse effect could be used as a therapeutic effect in patients with leukemia whose white blood cell counts were abnormally elevated. 85. What was the original source of taxane chemotherapy drugs, and why did that source change? Answer: The taxane chemotherapy drugs are so named because they were originally derived from an extract of the bark of the Pacific yew tree whose scientific name is Taxus brevifolia. Paclitaxel was the first of the taxane chemotherapy drugs. This yew tree, which only grows in the Pacific Northwest, is small and grows slowly, and collection of the bark kills the tree. Now, the needles of European and Himalayan yews are used because they contain 10 times more paclitaxel and harvesting of the needles does not kill the trees. 86. What happened when the drug thalidomide was used to treat morning sickness that almost ended any use of this drug? Answer: After the drug thalidomide was used to treat morning sickness in pregnant women in Europe and caused the severe birth defect of phocomelia (“seal limbs”) in their babies, it was withdrawn from the market. It would have become an obscure footnote in medical history but, in 1997, it was discovered to be useful in treating cancer, AIDS, and leprosy. Test Bank for Understanding Pharmacology for Health Professionals Susan M. Turley 9780135145708, 9780133911268