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Answer 53 =  Neurotoxicity
Source = Plant alkaloid derived from the periwinkle plant Catharanthus roseus.
Mechanism = Cell cycle–specific with activity in the mitosis (M) phase. Inhibits tubulin polymerization, disrupting formation of microtubule assembly during mitosis. This results in an arrest in cell division, ultimately leading to cell death.
Neurotoxicity = Most commonly observed dose-limiting toxicity. Clinical manifestations are variable, and include peripheral neuropathy (paresthesias, paralysis, and loss of deep tendon reflexes), autonomic nervous system dysfunction (orthostasis, sphincter problems, and paralytic ileus), cranial nerve palsies, ataxia, cortical blindness, seizures, and coma. Bone, back, limb, jaw, and parotid gland pain may also occur.
Constipation, abdominal pain, and paralytic ileus are common.