NEET PG / USMLE – MCQ 28
A 32-year-old man with non-Hodgkin lymphoma comes to the physician 6 days after finishing the initial chemotherapy regimen. His leukocyte count is 1600/mm3, indicating greater bone marrow suppression than expected. When questioned, the patient says that he has been taking Madagascar periwinkle as an herbal remedy for his condition. He obtains this substance from an herbalist. Which of the following is the most appropriate response by the physician?
(A) Ask the patient to stop using the herbal supplement because supplements are generally ineffective
(B) Continue the patient’s chemotherapy
(C) Explain the adverse effects this herbal supplement has on the patient’s treatment
(D) Report the herbalist to the Food and Drug Administration
(E) Suggest that the patient take daily multivitamin and protein supplements in addition to the herbal supplement
Correct answer : (C) Explain the adverse effects this herbal supplement has on the patient’s treatment
Catharanthus (Madagascar Periwinkle) is the source of the alkaloids vincristine and vinblastine – used in treatment for leukaemia and lymphoma. Hence it will cause additional bone marrow suppression.
C.EXPLAIN ADVERSE EFFECT OF HERBAL MEDICINE.
c
ans C)
e
madagascar periwinkle is vinca rosea hence that is causing the blood count of 1600 and also the patient is also on rx 4 nhl already he is immunosupressed nd this further decreases the blood count hence dis needs to be explained that this has an effect on the patient nd his future chance uf developing a malignancy nd such herbalists should also be reported to the fda bcos this type of unauthorised med cause more harm to the patient
C
madagascar periwinkle is a vinca alkaloid like vincristine which lowers the blood cell count. as pt is already on chemotherapy it is better to stop the herbal Rx to prevent further lowering of the blood cell count. moreover there is marked decrease in the count during 7th – 21st day of Rx. there r other side effects with the periwinkle. so ans is C.
c
c
c
c
C..
answer is (c) to explain the adverse effects of this herbal medicine madagascar periwinkle as it is a Vinca alkaloid which reduces the cell count further as he is already on chemotherapy for NHL.