Drugs used in Immune Disease - Methotrexate Flashcards
How can MTX be given?
Po, Im, Sc
What should patients do before prior to starting the therapy?
Patients should receive a test dose to rule out idiosyncratic adverse S/E
How often should MTX be taken?
Once a WEEK on the SAME DAY
What strenght tablets should MTX be prescribed?
2.5mg tabs
How LONG does MTX to work in RA?
Can take up for 6 week to see improvement
Then 12 weeks to feel its full effect.
What is the dose escelation for RA?
2.5mg - 5mg Increase every 1-3 weeks.
Aim for optimal dose in 4-6 weeks
What are the starting therapy baseline assessements?
FBC, LFT, U&E, Renal function, Chest X-Ray
Monitoring Therapy For MTX?
LFT, Renal Function, FBC -
Every 1-2 weeks until therapy stabilised
Once stabilised every 2-3 months.
What are the Pt self monitoring?
Signs of infection - sore throat.
Bruising, Bleeding - Indicate blood disorders.
Nausea, vomiting, abdominal & dark urine - indicating liver toxicity.
SOB indicating respiratory failure
Key S/E?
Bone marrow suppression
GI Toxicity
Liver Toxicity
Pulmonary Toxicity
Skin reactions.
Key contraindications?
Active infection
Severe renal impairment
Hepatic impairement
Bone marrow supression
Immunodeficiency
Pregnancy & Breast feeding
What should be co-prescribed with MTX?
Folic Acid 5mg
When should folic acid be taken?
1-6 days a week NOT ON MTX DAYS
What does taking folic acid do?
Reduces risk of hepatotoxicity & GI s/e
What should you do if you missed a dose of MTX?
Doses can be taken with 2 days
