Vincristine sulphate MCQs With Answer

Vincristine sulphate MCQs With Answer — a focused review designed for B. Pharm students. This question set explores vincristine sulphate, a vinca alkaloid anticancer agent, covering mechanism of action (microtubule inhibition during M‑phase), pharmacokinetics (CYP3A4 metabolism, hepatic dose adjustment), dosing principles (IV administration, typical dosing and capping), major toxicities (dose‑limiting peripheral neuropathy, autonomic effects, vesicant risk), contraindications (avoid intrathecal use), extravasation management, drug interactions and monitoring parameters. Questions emphasize clinical pharmacy relevance, safe chemotherapy handling, counselling points and evidence-based precautions. Study these items to reinforce your understanding of vincristine’s pharmacology and safe clinical use. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. What is the primary mechanism of action of vincristine sulphate?

• Inhibition of topoisomerase II leading to DNA strand breaks
• Alkylation of DNA guanine bases causing cross-linking
• Binding to tubulin and inhibiting microtubule polymerization
• Intercalation into DNA and inhibition of RNA synthesis

Correct Answer: Binding to tubulin and inhibiting microtubule polymerization

Q2. Vincristine is classified pharmacologically as which of the following?

• Anthracycline antibiotic
• Alkylating agent
• Vinca alkaloid
• Antimetabolite

Correct Answer: Vinca alkaloid

Q3. Vincristine’s cytotoxic effect is most prominent in which phase of the cell cycle?

• G1 phase
• S phase
• G2 phase
• M phase (mitosis)

Correct Answer: M phase (mitosis)

Q4. Which route of administration is absolutely contraindicated for vincristine due to risk of fatality?

• Intravenous bolus
• Intramuscular injection
• Intrathecal injection
• Subcutaneous injection

Correct Answer: Intrathecal injection

Q5. What is the common adult single-dose regimen parameter often used to limit vincristine neurotoxicity?

• Maximum single dose capped at 2 mg
• Maximum daily dose of 10 mg
• Continuous infusion over 7 days
• Oral dosing twice daily

Correct Answer: Maximum single dose capped at 2 mg

Q6. The major dose-limiting toxicity associated with vincristine is:

• Cardiotoxicity
• Severe myelosuppression
• Peripheral neuropathy
• Nephrotoxicity

Correct Answer: Peripheral neuropathy

Q7. Vincristine is primarily metabolized by which hepatic enzyme system?

• CYP2D6
• CYP3A4
• UGT1A1
• Alcohol dehydrogenase

Correct Answer: CYP3A4

Q8. Which of the following drugs can increase vincristine toxicity by inhibiting its metabolism?

• Rifampicin
• Phenytoin
• Itraconazole
• Carbamazepine

Correct Answer: Itraconazole

Q9. In the event of vincristine extravasation, the recommended initial antidotal management often includes:

• Apply ice and immobilize the limb
• Immediate intrathecal washout
• Administration of hyaluronidase and warm compresses
• Oral activated charcoal

Correct Answer: Administration of hyaluronidase and warm compresses

Q10. Compared to vinblastine, vincristine is characterized by which clinical distinction?

• Greater myelosuppression and less neurotoxicity
• Less vesicant potential
• More pronounced neurotoxicity and less myelosuppression
• Oral bioavailability is higher

Correct Answer: More pronounced neurotoxicity and less myelosuppression

Q11. Which monitoring parameter is most important to assess before each vincristine dose?

• Serum creatinine concentration
• Baseline ECG for QT prolongation
• Hepatic function tests (bilirubin, transaminases)
• Serum potassium level

Correct Answer: Hepatic function tests (bilirubin, transaminases)

Q12. Vincristine’s vesicant property requires which handling precaution during IV administration?

• Administer by rapid intra-arterial injection
• Ensure secure IV access and avoid peripheral infiltration
• Always deliver via intramuscular injection
• Mix with alkaline solutions to reduce irritation

Correct Answer: Ensure secure IV access and avoid peripheral infiltration

Q13. Which autonomic side effect commonly occurs with vincristine therapy?

• Hyperactive bowel sounds and diarrhea
• Constipation and ileus
• Excessive salivation and drooling
• Severe bronchospasm

Correct Answer: Constipation and ileus

Q14. For patients with significant hepatic impairment, the appropriate pharmacotherapy consideration for vincristine is:

• No dose adjustment is necessary
• Increase dose due to reduced clearance
• Reduce dose or delay treatment because clearance is decreased
• Switch to oral vincristine formulation

Correct Answer: Reduce dose or delay treatment because clearance is decreased

Q15. Which of the following counseling points is essential for patients receiving vincristine?

• Expect immediate hair regrowth within a week
• Avoid grapefruit juice and inform provider about antifungal use
• It is safe to receive live vaccines during therapy
• There is no need to report numbness or tingling

Correct Answer: Avoid grapefruit juice and inform provider about antifungal use

Q16. Vincristine sulfate is most appropriately stored under which conditions in the pharmacy?

• Room temperature, exposed to direct sunlight
• Frozen at −20°C without protection from light
• Refrigerated at 2–8°C and protected from light
• At room temperature in an alkaline solution

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

Q17. Which statement about vincristine-induced neuropathy is true?

• It is rapidly reversible in all patients after stopping drug
• It primarily affects sensory and motor peripheral nerves and can be cumulative
• It manifests solely as central nervous system confusion
• It is prevented completely by concurrent corticosteroids

Correct Answer: It primarily affects sensory and motor peripheral nerves and can be cumulative

Q18. Which formulation of vincristine has been developed to improve pharmacokinetics for certain leukemias?

• Oral vincristine tablets
• Liposomal vincristine sulfate injection
• Intrathecal vincristine solution
• Topical vincristine ointment

Correct Answer: Liposomal vincristine sulfate injection

Q19. Concomitant use of which agent can exacerbate vincristine neurotoxicity due to pharmacodynamic interaction?

• Amifostine
• Itraconazole
• Vinblastine
• Pregabalin

Correct Answer: Itraconazole

Q20. What is the main rationale for capping the single dose of vincristine (e.g., 2 mg cap)?

• To prevent cardiotoxicity at higher doses
• To limit cumulative peripheral neuropathy risk
• To avoid renal tubular necrosis
• To enhance oral absorption

Correct Answer: To limit cumulative peripheral neuropathy risk

Q21. Which laboratory abnormality is least commonly associated with vincristine therapy?

• Marked neutropenia
• Transient elevation of liver enzymes
• Normal or mild myelosuppression compared to other agents
• Electrolyte disturbances secondary to vomiting

Correct Answer: Marked neutropenia

Q22. Which of the following is a key safety practice during preparation of vincristine in the pharmacy?

• Prepare on an open bench without gloves
• Use appropriate personal protective equipment and biological safety cabinet
• Dilute with concentrated sodium hydroxide
• Draw dose using a glass syringe only

Correct Answer: Use appropriate personal protective equipment and biological safety cabinet

Q23. What counselling should be given regarding vaccination for a patient on vincristine?

• All vaccines, including live vaccines, are safe during therapy
• Avoid live vaccines during immunosuppressive chemotherapy
• Live vaccines are recommended to prevent infection during therapy
• No vaccination considerations are necessary

Correct Answer: Avoid live vaccines during immunosuppressive chemotherapy

Q24. Which clinical sign would most suggest vincristine-induced autonomic neuropathy?

• Brisk deep tendon reflexes
• Severe constipation and urinary retention
• Acute vision loss
• Profuse sweating and hyperactivity

Correct Answer: Severe constipation and urinary retention

Q25. A pharmacist notices a vincristine order without dilution instructions for a peripheral IV. The best action is to:

• Administer as written immediately to avoid delay
• Contact the prescribing oncologist for clarification and ensure proper dilution and secure IV access
• Convert the order to an oral equivalent dose
• Replace vincristine with vinblastine automatically

Correct Answer: Contact the prescribing oncologist for clarification and ensure proper dilution and secure IV access

Q26. Which of the following best describes vincristine’s effect on bone marrow compared to other cytotoxic drugs?

• It causes severe, prolonged pancytopenia in most patients
• It generally causes less myelosuppression than many other common cytotoxics
• It exclusively causes thrombocytosis
• It causes immediate aplastic anemia within hours

Correct Answer: It generally causes less myelosuppression than many other common cytotoxics

Q27. Which patient factor most warrants dose reduction of vincristine?

• Mild controlled hypertension
• Severe hepatic dysfunction with elevated bilirubin
• Recent history of uncomplicated cataract surgery
• Well-controlled hypothyroidism on levothyroxine

Correct Answer: Severe hepatic dysfunction with elevated bilirubin

Q28. Which clinical scenario represents an absolute contraindication to administering vincristine?

• Active mild upper respiratory infection
• Administration into an intrathecal route by mistake or intention
• Concurrent use of an antihistamine for allergy
• Family history of diabetes mellitus

Correct Answer: Administration into an intrathecal route by mistake or intention

Q29. Which statement regarding vincristine dosing in pediatric patients is correct?

• Pediatric dosing never requires adjustment for body surface area
• Dosing is often calculated on body surface area (mg/m2) with age-appropriate adjustments
• Children should always receive the adult fixed 2 mg cap irrespective of size
• Vincristine is contraindicated in all pediatric patients

Correct Answer: Dosing is often calculated on body surface area (mg/m2) with age-appropriate adjustments

Q30. Which adverse effect should prompt immediate evaluation and possible dose modification during vincristine therapy?

• New onset peripheral neuropathy with paresthesia and motor weakness
• Mild transient headache lasting a few minutes
• Temporary mild elevation of appetite
• Slight improvement in sleep quality

Correct Answer: New onset peripheral neuropathy with paresthesia and motor weakness

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