Which cancer therapy drug can decrease B12 and folic acid?

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Prepare for the Certified Specialist in Geriatric Nutrition Exam. Utilize our resources with flashcards and multiple-choice questions, complete with detailed hints and explanations. Enhance your knowledge and get ready to ace your exam!

Multiple Choice

Which cancer therapy drug can decrease B12 and folic acid?

Explanation:
Methotrexate acts as a folate antagonist by inhibiting dihydrofolate reductase, which prevents regeneration of tetrahydrofolate. Without enough active folate, synthesis of thymidylate and purines slows, so DNA replication in rapidly dividing cells is impaired. This folate depletion is the reason why methotrexate lowers folate levels, and because B12 participates in one‑carbon metabolism related to folate’s cycle, disturbances in this pathway can be associated with reduced B12 activity or status as well. The other cancer drugs listed work through different mechanisms—forming DNA cross-links, intercalating DNA, or disrupting microtubules—and do not primarily reduce folate pools.

Methotrexate acts as a folate antagonist by inhibiting dihydrofolate reductase, which prevents regeneration of tetrahydrofolate. Without enough active folate, synthesis of thymidylate and purines slows, so DNA replication in rapidly dividing cells is impaired. This folate depletion is the reason why methotrexate lowers folate levels, and because B12 participates in one‑carbon metabolism related to folate’s cycle, disturbances in this pathway can be associated with reduced B12 activity or status as well. The other cancer drugs listed work through different mechanisms—forming DNA cross-links, intercalating DNA, or disrupting microtubules—and do not primarily reduce folate pools.

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