Chemotherapy: glucarpidase: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Chemotherapy: glucarpidase

Sample item

A patient treated with high-dose methotrexate has rising creatinine, a markedly elevated methotrexate level at 48 hours and mucositis despite leucovorin. Which agent rapidly degrades methotrexate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Glucarpidase

Glucarpidase is a recombinant carboxypeptidase that converts methotrexate to inactive metabolites, rescuing patients with delayed clearance and renal failure. Mesna binds acrolein from ifosfamide, amifostine protects against cisplatin renal toxicity and dexrazoxane protects against anthracycline cardiotoxicity.

Option by option

  • A. Dexrazoxane

    Dexrazoxane protects the heart from doxorubicin.

  • B. Amifostine

    Amifostine is a cytoprotectant for cisplatin.

  • C. Mesna

    Mesna protects against haemorrhagic cystitis.

  • D. Glucarpidase (correct)

    Correct. Glucarpidase hydrolyses methotrexate.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pharmacology questions

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Glucarpidase. Glucarpidase is a recombinant carboxypeptidase that converts methotrexate to inactive metabolites, rescuing patients with delayed clearance and renal failure.

Why is "Dexrazoxane" not the answer?

Dexrazoxane protects the heart from doxorubicin.

Why is "Amifostine" not the answer?

Amifostine is a cytoprotectant for cisplatin.

Why is "Mesna" not the answer?

Mesna protects against haemorrhagic cystitis.

What concept does this question test?

It tests Chemotherapy: glucarpidase in Pharmacology. Mesna binds acrolein from ifosfamide, amifostine protects against cisplatin renal toxicity and dexrazoxane protects against anthracycline cardiotoxicity.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Chemotherapy: glucarpidase?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.