American Board of Surgery Qualifying Exam (ABS QE) Practice Test

Which of the following drugs is a known uroprotector for Ifosfamide-induced toxicity?

1. Methotrexate

2. Leucovorin

3. Mesna

4. Carboplatin

The correct answer is: Mesna

Mesna is a well-established uroprotector that is used to mitigate the toxicity associated with Ifosfamide, particularly in preventing hemorrhagic cystitis. Ifosfamide is an alkylating agent that can lead to the formation of toxic metabolites, which can irritate the bladder and cause damage. Mesna acts by binding to these toxic metabolites in the urine and neutralizing them, thus reducing the risk of bladder injury and allowing for safer administration of Ifosfamide. The other drugs listed serve different purposes in cancer treatment. Methotrexate is an antimetabolite used to interfere with DNA synthesis, often employed in treating various malignancies, but it does not provide protective effects against Ifosfamide toxicity. Leucovorin is used as a rescue medication following high-dose methotrexate therapy to protect normal tissues from toxicity but is not relevant for Ifosfamide-induced effects. Carboplatin, another chemotherapeutic agent, is also unrelated to uroprotection in the context of Ifosfamide toxicity. Thus, Mesna is specifically designed to counteract the urotoxic effects associated with Ifosfamide, making it the correct choice in this scenario.