Thursday, April 9, 2015

Mustard

A patient with systemic lupus erythematosus and systemic vasculitis is being counseled about taking the drug shown above. Within days to weeks of treatment, she will need her blood count closely followed because she may have decreased granulocytes, followed by thrombocytopenia, followed by anemia. Obviously, this increases her risk of infection. She is also counseled that this drug may cause premature ovarian failure, ovarian fibrosis, and permanent infertility. A pregnancy test is checked because the drug is highly teratogenic. Long-term, she needs to watch for lymphoma and other malignancies as well as cystitis and bladder cancer resulting from a toxic metabolite excreted in the urine.

Challenge: What is the drug?

Image is in the public domain.

3 comments:

RaH said...

this is Cyclophosphamide...
it interferes with the DNA replication causing anemia etc.
and as it is an "amine" it is cancerogenous for the Urothelcarcinoma.

would be nice to get the answers to the other cases a little faster...

cheers

Anna said...

That is cyclophosphamide, a nitrogen mustard.

Craig Chen said...

yep - i don't see cyclophosphamide often so i found it helpful to review. will try to update answers quicker, it's very dependent on how busy real life is for me
-
Mustard

Cyclophosphamide is the nitrogen mustard alkylating agent shown here.

Sources: UpToDate; Wikipedia.