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NBME 17 Answers

nbme17/Block 0/Question#0 (reveal difficulty score)
6-mercaptopurine (6-MP) is used to treat ...
They must be given decreased doses of 6-MP ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—cassdawg(1780)
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These individuals have a poluymorphism in the breakdown pathway of 6-MP. Like most polymorphisms in drug breakdown pathways, this will lead to buildup of toxic metabolites unless the drug dose is decreased (i.e. the 6-MP will be shunted into the pathway that makes the toxic 6-thioguanine).

6-MP and its prodrug azothioprine inhibit purine synthesis (FA2020 p36 and p440).

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ali_hassan  my pea-sized brain doesn't understand why not give injections of XO. help +2
harbourlights  that's what I put. Because if you decreased their dosage wouldn't also cause a decrease in the final 6-TGN concentration making it less effective? +2
amira89  what is thiopurine methyltransferase (TPMT) and where does it act? +1
specialist_jello  qid 1890 +1



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submitted by โˆ—namesthegame22(13)
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p. 120 FA (2018)

6-MP degraded by XO. So toxicity is increased by allopurinol (which blocks XO).

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