1
Q
frequency of methotrexate
A
once weekly
2
Q
what is required on prescription and label
A
dose and frequency clearly
3
Q
what is commonly co-prescribed with methotrexate
A
- folic acid
- not on same day
4
Q
what should pt immediately report signs of
A
- blood disorder
- liver toxicity
- respiratory effects
5
Q
methotrexate s/e
A
- blood disorders
- liver toxicity
- pulmonary toxicity
- GI toxicity
6
Q
blood disorders symptoms
methotrexate s/e
A
- sore throat
- bruising
- mouth ulcers
7
Q
liver toxicity symptoms
methotrexate s/e
A
- N+V
- abdominal discomfort
- dark urine
- jaundice
- itchy skin
8
Q
pulmonary toxicity symptoms
methotrexate s/e
A
- SoB
- coughing
9
Q
GI toxicity symptoms
A
- stomatitis
- diarrhoea
10
Q
toxicity antidote
A
folinic aicd (calcium folinate)
11
Q
methotrexate monitoring
A
- FBC
- renal function tests
- LFT
- every 1-2wk until stable then every 2-3MT
12
Q
methotrexate screening
A
- screen no pregn prior to tx
- antifolate = harmful to fetus
- use effective contraception during + 6mt after
13
Q
methotrexate interactions
A
- nephrotoxic drugs = no otc ibuprofen NSAIDs
- antifolates = trimethoprim + phenytoin
- hepatotoxic drugs = rifampicin + antifungals
- omeprazole/esomeprazole
14
Q
why is nephrotoxic drugs not given with MTX
A
MTX reduces renal function
15
Q
why is omeprazole/esomeprazole not given
A
reduces clearance and increases toxicity
16
Q
MHRA warning
A
Caution in sun due to photosensitivity in methotrexate
MUSK
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Decks in class (5)
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