Advanced Pharmacology Final Verified Exam Questions and Answers
Latest update 2026/2027
Question:
1. Adjuvant chemotherapy is administered radiation and surgery.
Answer:
After
Question:
2. What is the purpose of adjuvant chemotherapy?
Answer:
To eliminate micro metastases and any cancer cells that may have broken off from surgical
intervention
Question:
3. Neoadjuvant chemotherapy is administered surgery.
Answer:
before
Question:
4. What is the purpose of neoadjuvant chemotherapy? To shrink the tumor be-
Answer:
fore surgery: it does not increase survival. Changes the timing of treatment, can change surgical
options if the tumor is shrunk enough. Makes the tumor more amenable to surgery. (e.g., the patient
may only require a lumpectomy plus radiation therapy instead of needing a mastectomy)
Question:
5. Doxorubicin administration requires what baseline as- Cardiac function assesssessment?
Answer:
ment, such as an echocardiogram. Doxorubicin has cardiac toxicity
Question:
6. Why does doxorubicin require a cardiac function assessment prior to administration?
Answer:
Doxorubicin generates free iron radicals that damages DNA. The result is irreversible, dose-dependent
damage to myocardial cells, which may lead to cardiomyopathy and congestive heart failure.
,Question:
7. Anthracyclines
Answer:
doxorubicin, daunorubicin
Question:
8. Adverse effects with ifosfamide
Answer:
Neurotoxicity, hemorrhagic cystitis, myelosuppression, GI tract complications, increased risk of
malignancies
Question:
9. What must be administered with ifosfamide to prevent toxicity?
Answer:
Aggressive IV hydration Mesna (an alternative substance for the drug to act on so nephrotoxicity is
limited) Frequent urinalysis
Question:
10. Mesna must be administered with to reduce the risk of . It does this by inactivating the metabolite
Answer:
- ifosfamide
- hemorrhagic cystitis
- acrolein
Question:
11. Cisplatin toxicities
Answer:
- Nephrotoxic
- Neurotoxic
- Ototoxic
- Electrolyte imbalances
- HIGHLY Emetogenic -
you do not administer this drug without a strong antiemetic
Question:
12. What drug is lethal intrathecally?
Answer:
Vincristine/Vinblastine.
,Question:
13. Intrathecal administration
Answer:
injection into the spinal canal, or into the subarachnoid space
Question:
14. Why is vincristine lethal intrathecally and can only be administered via IV?
Answer:
Vincristine, a vinca alkaloid, functions by disrupting cell division and causing dissolution of the
myotic spindle.
Question:
15. Rituximab is a monoclonal antibody against
Answer:
CD20 on B cells, causing B-cell lysis
Question:
16. Why must Rituximab administrations (IV route) be monitored extremely carefully?
Answer:
Because Rituximab can cause cytokine release syndrome and anaphylaxis. This occurs because
Rituximab lyses B-cells --> rapid cytokine release from the lysed cells
Question:
17. Cytokine Release Syndrome (CRS) is:
Answer:
Fever, tachycardia, hemodynamic instability resulting from T-cell targeting therapies.
Question:
18. How do you offset the potential adverse effects of rituximab administration?
Answer:
Premedicate with:
Acetaminophen Antihistamines (diphenhydramine) Corticosteroids (methylprednisone)
Question:
19. What is a consideration before administering bortezomib?
Answer:
Prophylaxis against the reactivation of herpes zoster (shingles)
, Question:
20. Why does bortezomib reactivate shingles, and what can be administered to prevent it?
Answer:
Bortezomib is an proteasome inhibitor and immunosuppresses the body, which may reactivate herpes
zoster. Prophylactic antiviral therapy (acyclovir) is recommended.
Question:
21. What is the dose-limiting toxicity with cisplatin?
Answer:
Nephrotoxicity (distal tubule and collecting duct)
Question:
22. Why does cisplatin cause renal toxicity?
Answer:
Cisplatin accumulates significantly in the kidneys, causing apoptosis/necrosis in the renal cells.
Question:
23. Cisplatin causes nephrotoxicity: what are some adverse consequences of this?
Answer:
poor renal perfusion, high emetic potential, electrolyte disturbances, elevated creatinine, acute kidney
injury
Question:
24. How do we prevent cisplatin toxicity?
Answer:
We prevent this by:
- administering aggressive IV hydration
pre-treatment
- avoiding patients with
poor renal perfusion
- considering alternative
therapies.
Question:
25. Which PPIs should be avoided with clopidogrel (a pro- Omeprazole and esdrug), warfarin,
diazepam, and phenytoin?
Answer:
omeprazole (Due to CYP 2C19 inhibition, which is the enzyme that "activates" clopidogrel)
Latest update 2026/2027
Question:
1. Adjuvant chemotherapy is administered radiation and surgery.
Answer:
After
Question:
2. What is the purpose of adjuvant chemotherapy?
Answer:
To eliminate micro metastases and any cancer cells that may have broken off from surgical
intervention
Question:
3. Neoadjuvant chemotherapy is administered surgery.
Answer:
before
Question:
4. What is the purpose of neoadjuvant chemotherapy? To shrink the tumor be-
Answer:
fore surgery: it does not increase survival. Changes the timing of treatment, can change surgical
options if the tumor is shrunk enough. Makes the tumor more amenable to surgery. (e.g., the patient
may only require a lumpectomy plus radiation therapy instead of needing a mastectomy)
Question:
5. Doxorubicin administration requires what baseline as- Cardiac function assesssessment?
Answer:
ment, such as an echocardiogram. Doxorubicin has cardiac toxicity
Question:
6. Why does doxorubicin require a cardiac function assessment prior to administration?
Answer:
Doxorubicin generates free iron radicals that damages DNA. The result is irreversible, dose-dependent
damage to myocardial cells, which may lead to cardiomyopathy and congestive heart failure.
,Question:
7. Anthracyclines
Answer:
doxorubicin, daunorubicin
Question:
8. Adverse effects with ifosfamide
Answer:
Neurotoxicity, hemorrhagic cystitis, myelosuppression, GI tract complications, increased risk of
malignancies
Question:
9. What must be administered with ifosfamide to prevent toxicity?
Answer:
Aggressive IV hydration Mesna (an alternative substance for the drug to act on so nephrotoxicity is
limited) Frequent urinalysis
Question:
10. Mesna must be administered with to reduce the risk of . It does this by inactivating the metabolite
Answer:
- ifosfamide
- hemorrhagic cystitis
- acrolein
Question:
11. Cisplatin toxicities
Answer:
- Nephrotoxic
- Neurotoxic
- Ototoxic
- Electrolyte imbalances
- HIGHLY Emetogenic -
you do not administer this drug without a strong antiemetic
Question:
12. What drug is lethal intrathecally?
Answer:
Vincristine/Vinblastine.
,Question:
13. Intrathecal administration
Answer:
injection into the spinal canal, or into the subarachnoid space
Question:
14. Why is vincristine lethal intrathecally and can only be administered via IV?
Answer:
Vincristine, a vinca alkaloid, functions by disrupting cell division and causing dissolution of the
myotic spindle.
Question:
15. Rituximab is a monoclonal antibody against
Answer:
CD20 on B cells, causing B-cell lysis
Question:
16. Why must Rituximab administrations (IV route) be monitored extremely carefully?
Answer:
Because Rituximab can cause cytokine release syndrome and anaphylaxis. This occurs because
Rituximab lyses B-cells --> rapid cytokine release from the lysed cells
Question:
17. Cytokine Release Syndrome (CRS) is:
Answer:
Fever, tachycardia, hemodynamic instability resulting from T-cell targeting therapies.
Question:
18. How do you offset the potential adverse effects of rituximab administration?
Answer:
Premedicate with:
Acetaminophen Antihistamines (diphenhydramine) Corticosteroids (methylprednisone)
Question:
19. What is a consideration before administering bortezomib?
Answer:
Prophylaxis against the reactivation of herpes zoster (shingles)
, Question:
20. Why does bortezomib reactivate shingles, and what can be administered to prevent it?
Answer:
Bortezomib is an proteasome inhibitor and immunosuppresses the body, which may reactivate herpes
zoster. Prophylactic antiviral therapy (acyclovir) is recommended.
Question:
21. What is the dose-limiting toxicity with cisplatin?
Answer:
Nephrotoxicity (distal tubule and collecting duct)
Question:
22. Why does cisplatin cause renal toxicity?
Answer:
Cisplatin accumulates significantly in the kidneys, causing apoptosis/necrosis in the renal cells.
Question:
23. Cisplatin causes nephrotoxicity: what are some adverse consequences of this?
Answer:
poor renal perfusion, high emetic potential, electrolyte disturbances, elevated creatinine, acute kidney
injury
Question:
24. How do we prevent cisplatin toxicity?
Answer:
We prevent this by:
- administering aggressive IV hydration
pre-treatment
- avoiding patients with
poor renal perfusion
- considering alternative
therapies.
Question:
25. Which PPIs should be avoided with clopidogrel (a pro- Omeprazole and esdrug), warfarin,
diazepam, and phenytoin?
Answer:
omeprazole (Due to CYP 2C19 inhibition, which is the enzyme that "activates" clopidogrel)
