A 13-year-old receiving ifosfamide-based chemotherapy for Ewing's sarcoma is simultaneously given mesna. The purpose of mesna in this setting is to prevent:
- A Ifosfamide-induced encephalopathy
- B Nephrotoxicity
- C Haemorrhagic cystitis ✓
- D Peripheral neuropathy
Correct answer: C. Haemorrhagic cystitis
Explanation
Ifosfamide is metabolised to acrolein, which is excreted in urine and directly injures urothelium, causing haemorrhagic cystitis. Mesna is a sulfhydryl compound that concentrates in urine and conjugates acrolein into an inert mercapturate, protecting the bladder. Aggressive hydration complements this. Encephalopathy from chloroacetaldehyde is not prevented by mesna, and cisplatin is the agent classically linked to nephrotoxicity and neuropathy in these regimens.
Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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