October 28, 2013

Concerning the side-effects of cytotoxics

Pulmonary abnormalities are a known side effect of several cytotoxic drugs. Of the many cytotoxics, which of the following cytotoxic drugs is most likely to lead to a pleural friction rub?
  1. Methotrexate
  2. 5-fluorouracil
  3. Taxoids
  4. Cyclopentenyl cytosine
  5. Trastuzumab

The correct answer is A

There are at least 40 drugs which may produce adverse pulmonary effects. The more common ones are bleomycin, busulfan, mitomycin, BCNU, arabinoside, IL2 and methotrexate.

The clinical features that may be encountered are:
  • dyspnoea,
  • cough,
  • pulmonary infiltrates,
  • basal inspiratory crackles,
and, rarely, pleural friction rub, pleural effusions, pulmonary fibrosis and eosinophilia.

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