Daunorubicin MCQs With Answer

Daunorubicin MCQs With Answer provides B.Pharm students a focused, practical review of daunorubicin — an important anthracycline chemotherapy agent. This concise introduction and question set emphasize mechanism of action, pharmacokinetics, clinical indications (notably AML), dosing considerations, cumulative cardiotoxicity, adverse effects, monitoring parameters, resistance mechanisms, administration precautions, and formulation/handling. Keywords included: daunorubicin, anthracycline, cardiotoxicity, pharmacokinetics, mechanism of action, myelosuppression, dexrazoxane, AML, infusion, and monitoring. Questions are designed to deepen understanding beyond basics and improve exam readiness and clinical reasoning. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which class of drugs does daunorubicin belong to?

• Alkylating agent
• Antimetabolite
• Anthracycline antibiotic
• Vinca alkaloid

Correct Answer: Anthracycline antibiotic

Q2. What is the primary mechanism of action of daunorubicin?

• Alkylation of guanine residues in DNA
• Intercalation into DNA and inhibition of topoisomerase II
• Inhibition of microtubule polymerization
• Folate antagonism inhibiting thymidylate synthesis

Correct Answer: Intercalation into DNA and inhibition of topoisomerase II

Q3. Daunorubicin is most commonly indicated for which malignancy?

• Breast cancer
• Chronic lymphocytic leukemia
• Acute myeloid leukemia (AML)
• Non-Hodgkin lymphoma

Correct Answer: Acute myeloid leukemia (AML)

Q4. What is the usual route of administration for daunorubicin in clinical practice?

• Oral
• Intramuscular
• Intravenous (IV) administration
• Subcutaneous

Correct Answer: Intravenous (IV) administration

Q5. Which is the major dose-limiting toxicity associated with daunorubicin?

• Hepatotoxicity
• Cumulative dose-dependent cardiotoxicity
• Renal failure
• Peripheral neuropathy

Correct Answer: Cumulative dose-dependent cardiotoxicity

Q6. Which investigation is essential for baseline and periodic monitoring of daunorubicin cardiotoxicity?

• Serum creatinine
• Liver function tests only
• Echocardiography to assess left ventricular ejection fraction (LVEF)
• Electrolyte panel only

Correct Answer: Echocardiography to assess left ventricular ejection fraction (LVEF)

Q7. What mechanism primarily explains anthracycline-induced cardiotoxicity?

• Autoimmune myocarditis
• Free radical-mediated oxidative damage to cardiac myocytes
• Direct viral infection of myocardium
• Deposition of immune complexes in coronary vessels

Correct Answer: Free radical-mediated oxidative damage to cardiac myocytes

Q8. Which agent is used as a cardioprotective antidote to reduce anthracycline cardiotoxicity?

• Amifostine
• Dexrazoxane
• Mesna
• N-acetylcysteine

Correct Answer: Dexrazoxane

Q9. How is daunorubicin primarily eliminated from the body?

• Renal excretion of unchanged drug
• Pulmonary metabolism
• Extensive hepatic metabolism and biliary excretion
• Exhalation as volatile metabolites

Correct Answer: Extensive hepatic metabolism and biliary excretion

Q10. What is the recommended dose adjustment principle for daunorubicin in hepatic impairment?

• No adjustment; give full dose
• Increase dose due to reduced clearance
• Reduce dose or delay therapy depending on bilirubin and AST/ALT
• Switch to oral formulation

Correct Answer: Reduce dose or delay therapy depending on bilirubin and AST/ALT

Q11. Which hematologic adverse effect is most characteristic of daunorubicin therapy?

• Hemolytic anemia
• Myelosuppression (bone marrow suppression)
• Eosinophilia
• Polycythemia

Correct Answer: Myelosuppression (bone marrow suppression)

Q12. Which color change of body fluids may patients experience after daunorubicin administration?

• Bright green urine
• Blue-gray skin discoloration
• Red-colored urine and red discoloration of tears
• Dark brown sclera

Correct Answer: Red-colored urine and red discoloration of tears

Q13. Which handling/storage precaution is important for daunorubicin vials or prepared solutions?

• Store exposed to light at room temperature
• Protect from light and use promptly after reconstitution
• Freeze before use to increase stability
• Keep at high humidity to prevent drying

Correct Answer: Protect from light and use promptly after reconstitution

Q14. Which diluent is commonly used to prepare daunorubicin infusion for administration?

• Absolute ethanol
• 5% Dextrose (D5W)
• 0.9% Calcium chloride solution
• Saturated sodium bicarbonate

Correct Answer: 5% Dextrose (D5W)

Q15. Which mechanism commonly contributes to tumor resistance to daunorubicin?

• Increased drug uptake via transporters
• Overexpression of P-glycoprotein (MDR1) causing drug efflux
• Enhanced topoisomerase II activity
• Increased intracellular activation of the drug

Correct Answer: Overexpression of P-glycoprotein (MDR1) causing drug efflux

Q16. The phrase “cumulative dose-related toxicity” for daunorubicin refers to which concept?

• Toxicity that occurs only after the first dose
• Toxicity that increases with the total lifetime dose of the drug
• Toxicity unrelated to dose or duration
• Toxicity that decreases with successive doses

Correct Answer: Toxicity that increases with the total lifetime dose of the drug

Q17. What is the recommendation regarding daunorubicin use during pregnancy?

• Safe in all trimesters
• Use without dose adjustment
• Contraindicated in pregnancy due to teratogenicity
• Only oral use is allowed

Correct Answer: Contraindicated in pregnancy due to teratogenicity

Q18. Which best describes daunorubicin’s activity in relation to the cell cycle?

• Strictly S-phase specific
• G2-phase specific only
• Cell cycle non-specific (affects multiple phases)
• M-phase specific like vinca alkaloids

Correct Answer: Cell cycle non-specific (affects multiple phases)

Q19. Daunorubicin is commonly combined with which agent for induction therapy in AML?

• Cisplatin
• Cytarabine (Ara-C)
• Vincristine
• Methotrexate

Correct Answer: Cytarabine (Ara-C)

Q20. What is the recommended immediate management for daunorubicin extravasation?

• Ignore and continue infusion
• Flush with large volumes of saline only
• Stop infusion, aspirate drug if possible, and administer dexrazoxane per protocol
• Warm compresses and give oral antibiotics only

Correct Answer: Stop infusion, aspirate drug if possible, and administer dexrazoxane per protocol

Q21. By intercalating into DNA, daunorubicin primarily causes which downstream effect?

• Enhanced RNA polymerase activity
• Inhibition of DNA replication and RNA synthesis leading to cell death
• Promotion of DNA repair
• Stabilization of microtubules

Correct Answer: Inhibition of DNA replication and RNA synthesis leading to cell death

Q22. Which acute non-hematologic adverse effect is commonly seen soon after daunorubicin administration?

• Severe chronic neuropathy
• Nausea and vomiting
• Permanent alopecia in all patients
• Immediate renal failure

Correct Answer: Nausea and vomiting

Q23. How should unopened daunorubicin vials typically be stored?

• At room temperature exposed to sunlight
• Frozen at -20°C
• Refrigerated (2–8°C) and protected from light
• Kept in a desiccator without refrigeration

Correct Answer: Refrigerated (2–8°C) and protected from light

Q24. Which administration route is absolutely contraindicated for daunorubicin due to fatal outcomes?

• Intravenous
• Intra-arterial
• Intrathecal
• Intramuscular

Correct Answer: Intrathecal

Q25. What is the usual pharmaceutical form of daunorubicin used in hospitals?

• Oral tablet
• Topical cream
• Daunorubicin hydrochloride (injectable)
• Inhalation aerosol

Correct Answer: Daunorubicin hydrochloride (injectable)

Q26. What reproductive effect may daunorubicin have in patients of reproductive age?

• Enhances fertility temporarily
• No effect on fertility
• May cause infertility in both genders
• Causes only reversible changes in sperm count with no long-term effects

Correct Answer: May cause infertility in both genders

Q27. Which laboratory parameter requires frequent monitoring during daunorubicin therapy?

• Fasting blood glucose only
• Complete blood count (CBC) for neutropenia and thrombocytopenia
• Urine pregnancy test only once before therapy
• Serum magnesium only

Correct Answer: Complete blood count (CBC) for neutropenia and thrombocytopenia

Q28. When is the expected nadir for neutrophil count after a typical daunorubicin dose?

• Within 24 hours
• 7–14 days after administration
• 6 months after therapy
• There is no predictable nadir

Correct Answer: 7–14 days after administration

Q29. Concomitant use of strong CYP3A4 inhibitors with daunorubicin is likely to cause what?

• Decrease in daunorubicin plasma levels and reduced efficacy
• No interaction at all
• Increase in daunorubicin plasma levels and risk of toxicity
• Immediate allergic reaction in all patients

Correct Answer: Increase in daunorubicin plasma levels and risk of toxicity

Q30. What is a key advantage of liposomal daunorubicin formulations compared to conventional formulation?

• Increased renal excretion leading to nephrotoxicity
• Reduced cardiotoxicity and altered tissue distribution improving tolerability
• Complete oral bioavailability
• Guaranteed absence of myelosuppression

Correct Answer: Reduced cardiotoxicity and altered tissue distribution improving tolerability

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