Paper II
2023 July (Supplementary) (2019 Scheme) · 100 marks · 180 min

Question

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  • (a) Describe the uses and adverse effects of Ceftriaxone. ( 4 mark(s)
  • (b) Discuss the toxicity of Anticancer drugs and ways to manage the same 4 mark(s)
Q38 marksShort Essays

Answer

a) Ceftriaxone — uses and adverse effects A third-generation cephalosporin with excellent CSF penetration and broad Gram-negative coverage. Uses: bacterial meningitis, gonorrhoea, severe Gram-negative sepsis, typhoid fever, community-acquired pneumonia. Adverse effects: hypersensitivity reactions (partial cross-reactivity with penicillin allergy), diarrhea, biliary sludging (from biliary excretion), increased C. difficile colitis risk.

b) Toxicity of anticancer drugs and management Anticancer drugs characteristically damage rapidly dividing normal cells alongside tumour cells, producing predictable toxicities:

  • Bone marrow suppression — the most common dose-limiting toxicity; managed with growth factor support (G-CSF), blood/platelet transfusion, dose delay/reduction, and infection precautions during neutropenia.
  • Nausea and vomiting — managed with 5-HT3 antagonists, NK1 antagonists, and corticosteroids (per emetogenic risk category of the regimen).
  • Mucositis and GI toxicity — supportive oral care, analgesia.
  • Alopecia — reversible after treatment completion; scalp cooling can reduce severity with some agents.
  • Organ-specific toxicities — cardiotoxicity (doxorubicin, managed by cumulative dose limits and cardiac monitoring), nephrotoxicity (cisplatin, managed by aggressive hydration), hemorrhagic cystitis (cyclophosphamide, prevented with mesna).
  • Extravasation injury — managed by immediate stopping of infusion, local measures, and specific antidotes for vesicant agents where available.

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