Methotrexate counselling Flashcards
1
Q
Check for contraindications
A
- Pregnancy (including male partner)
- Breast-feeding
- Hepatic impairment
- Active infection
- Immunodeficiency
2
Q
How the treatment works
A
- It is a ‘disease-modifying agent’ which reduces inflammation and suppresses the immune system
- Early use improves outcomes and symptoms
3
Q
Treatment course and how it’s taken
A
- Once weekly tablet with folic acid tablet on another day
- Same day each week
- Dose built up slowly
- Taken long-term if effective
- Takes 3-12 weeks to work
3
Q
Treatment course and how it’s taken
A
- Once weekly tablet with folic acid tablet on another day
- Same day each week
- Dose built up slowly
- Taken long-term if effective
- Takes 3-12 weeks to work
4
Q
Monitoring required
A
- FBC, LFTs, U&Es before starting
- Then, every 2 weeks until therapy stabilised
- Then, every 2-3 months
- Patient should be given monitoring book
5
Q
Side effects
A
- Alopecia
- Headaches
- GI disturbance - advise not to take NSAIDs/aspirin
- Myelosuppression (infections, unexpected bruising/bleeding, anaemia) - seek medical advice if you have unexplained bruising/bleeding or have infective symptoms, and get annual flu jab!
- Liver and lung toxicity