Bryant: Pharmacology for Health Professionals, 5th Edition

Chapter 25: Drugs Affecting the Haemopoietic System

Test Bank

Multiple Choice

1. A patient complains of lethargy and fatigue and is found to have low blood haemoglobin levels. The most appropriate drug therapy is:

A. Vitamin K

B. Filgrastim

C. Iron

D. None of the above

ANS: C

A condition in which there is a reduced oxygen-carrying capacity of the blood (due to reduced amount or functionality of haemoglobin) is referred to as anaemia and often manifests as fatigue. Iron deficiency anaemia is characterised by small red cells with reduced haemoglobin. Agents commonly used to treat this condition are the haematinics: folic acid, iron and vitamin B12.

2. Folic acid can be used to:

A. Treat folate-deficiency anaemia

B. Prevent neural tube defects in the growing fetus

C. Prevent toxicity from methotrexate

D. All of the above

ANS: D

Folic acid is essential for DNA synthesis, and dietary folic acid is reduced to tetrahydrofolate (FH4). Folic acid is used to treat folate-deficiency anaemia, to prevent neural tube defects in the growing fetus and to treat or prevent toxicity from the antimetabolite drug methotrexate.

3. Common adverse reactions associated with erythropoietin include:

A. Hypertension

B. Flu-like symptoms

C. Peripheral oedema

D. All of the above

ANS: D

Adverse reactions associated with erythropoietin use are common and include hypertension (due to a rapid rise in haemoglobin), flu-like symptoms (e.g. headache, bone pain, myalgia and fever) and rash, peripheral oedema, dyspnoea and GI disturbances (e.g. nausea, vomiting and diarrhoea).

4. A middle-aged woman exhibits severe neutropenia following a course of chemotherapy for breast cancer. The most appropriate drug therapy to treat her is:

A. Aspirin

B. Vitamin K

C. Filgrastim

D. Iron ANS: C

Colony-stimulating factors are cytokines that regulate cell proliferation, differentiation and growth through an action on progenitor cells. Currently available CSFs include ancestim, a recombinant stem cell factor, which is produced by bone marrow fibroblasts, and the granulocyte colony-stimulating factors (G-CSF) filgrastim and pegfilgrastim and lenograstim. G-CSF is primarily regarded as a haematopoietic growth factor of the granulocyte lineage controlling the development of neutrophils. The G-CSFs are indicated for the treatment of chemotherapy/drug-induced neutropenia, severe chronic neutropenia and autologous and allogeneic bone marrow transplantation.

5. An elderly patient with diabetic nephropathy and end-stage renal disease exhibits symptoms of pernicious anaemia. The most appropriate drug therapy is:

A. Aspirin

B. Streptokinase

C. Cyanocobalamin

D. All of the above

ANS: C

Cyanocobalamin (also known as Vitamin B12) is used principally to treat pernicious anaemia and optic neuropathies (the vitamin is essential to nerve development).