Methotrexate

Question 1

Methotrexate Action

Answer 1

Stops cell reproduction needed for the synthesis of DNA by inhibiting folic acid conversion

S- phase specific

Question 2

Methotrexate therapeutic use

Answer 2

Choriocarcinoma, solid tumors, head and neck sarcomas, osteogenic sarcoma, acute lymphatic leukemia, non-Hodgkins lymphoma, T-cell lymphoma

Management of rheumatoid arthritis, psoriasis, and Crohns disease

Question 3

Methotrexate

Answer 3

Antineoplastic

Question 4

Methotrexate complications

Answer 4

bone marrow suppression

GI discomfort ( N/V)

gastric ulcers

Renal damage

Question 5

Methotrexate interactions?

Answer 5

Salicylates

NSAIDS

Sulfonamides

Penicillin

tetracycline

( ALL CAUSE TOXICITY)

Question 6

Methotrexate Education

Answer 6

Monitor for GI bleed ( coffee ground emesis or tarry black stool)

Provide frequent oral hygiene using soft toothbrush and avoid alcohol mouthwashes

avoid being pregnant while taking these meds

notify provider about monitoring breath sounds

Notify about N/V and fever

Admin with Leucovorin rescue to reduce toxicity to healthy cells ( folic acid derivative)

Question 7

Methotrexate Contraindications/ Precautions

Answer 7

renal or hepatic failure

blood dyscrasia

Pregnancy and lactation

Use with caution in people who have liver/ dysfunction, suppressed bone marrow, leukopenia, Thromocytopenia, anemia, gastric ulcers

Question 8

Methotrexate Dose

Answer 8

7.5mg/week

20mg MAX/week