Anti-neoplastics

Question 1

METHOTREXATE

Trexall

Answer 1

Treatment of cancer, mycosis fungoides, psoriasis, rheumatoid arthritis
PO, IM, IV: onset 4-7 days, peak 7-14 days, lasts 21
Avoid crowds and people with known infections
Do not take with ASA or other NSAIDs – may cause GI bleeding
Monitor for pulmonary toxicity, early as a dry, nonproductive cough
Preg Cat X

Side Effects:
N/V, Diarrhea, Anorexia, Alopecia, Ulcerative Stomatitis, Dizziness

Question 2

TAMOXIFEN

Answer 2

Management of advanced breast cancer not responsive to other therapy in estrogen receptor positive patients
To decrease GI upset – take after antacid, an evening meal. before bedtime, or anti-emetic 1/2 - 1 hr before
Vaginal bleeding, pruritus, hot flashes are reversible after stopping med
Contact Dr: decreased visual acuity – may be irriversible
Tumor flare may occur, can decrease rapidly – take analgesics for pain
Preg Cat D

Side Effects:
N/V, hot flashes, rash, vaginal discharge, irregular menses, fluid retention, depression, mood disturbances