Chemotherapy: apremilast: 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: apremilast

Sample item

A patient with psoriatic arthritis is given apremilast, an oral small molecule that inhibits phosphodiesterase 4. Which adverse effects are characteristic?

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

The answer and the reasoning

B. Diarrhoea, nausea, weight loss and depression

Apremilast inhibits PDE4, raising cAMP in immune cells and lowering production of TNF, IL-17 and IL-23. It requires no routine laboratory monitoring, and its common adverse effects are diarrhoea, nausea, headache, weight loss and depression. It is used in psoriasis, psoriatic arthritis and Behcet oral ulcers.

Option by option

  • A. Bradycardia and macular oedema

    Bradycardia with macular oedema is typical of fingolimod.

  • B. Diarrhoea, nausea, weight loss and depression (correct)

    Correct. Gastrointestinal upset, weight loss and mood change are typical of PDE4 inhibition.

  • C. Neutropenia and opportunistic infections

    Neutropenia with opportunistic infection is a concern with immunosuppressants such as azathioprine.

  • D. Hepatic necrosis and pancreatitis

    Hepatic necrosis and pancreatitis are not characteristic of apremilast.

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 B, Diarrhoea, nausea, weight loss and depression. Apremilast inhibits PDE4, raising cAMP in immune cells and lowering production of TNF, IL-17 and IL-23.

Why is "Bradycardia and macular oedema" not the answer?

Bradycardia with macular oedema is typical of fingolimod.

Why is "Neutropenia and opportunistic infections" not the answer?

Neutropenia with opportunistic infection is a concern with immunosuppressants such as azathioprine.

Why is "Hepatic necrosis and pancreatitis" not the answer?

Hepatic necrosis and pancreatitis are not characteristic of apremilast.

What concept does this question test?

It tests Chemotherapy: apremilast in Pharmacology. It requires no routine laboratory monitoring, and its common adverse effects are diarrhoea, nausea, headache, weight loss and depression. It is used in psoriasis, psoriatic arthritis and Behcet oral ulcers.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: apremilast?

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.