Methotrexate

Question 1

Drug Class

Answer 1

Folic acid antagonist

Question 2

Active

Answer 2

Methotrexate

Question 3

Indications

Answer 3

Treatment and palliation of solid tumours, lymphoma and leukaemia

Severe disabling psoriasis

Rheumatoid arthritis

Question 4

Dose Range

Answer 4

Arthritis/Psoriasis:

5 – 25 mg ONCE WEEKLY

Question 5

SE’s

Answer 5

• Myelosuppression (neutropenia, thrombocytopenia)
• GI side effects (mucositis, ulceration, n, v)
• Pulmonary toxicity
• Hepatotoxicity
• Rash, urticaria, itch
• Photosensitivity

Question 6

Counselling

Answer 6

Labels: 8, 10a, 20, 21

• Take tablets strictly as directed. They should be taken ONE A WEEK on the same day each week; they must not be taken every day.
• Tell your doctor if you have a cough, difficulty breathing or signs of infection.
• Avoid excessive or prolonged sun exposure, wear protective clothing and use sunscreen.
• Use of some medications together with methotrexate may lead to toxicity; tell your doctor and pharmacist that you are taking this drug.
• You may need to attend regular blood tests and medical consultations while being treated with this medication.
• Take a folic acid (5 mg) tablet on every other day than that of the methotrexate to reduce GI side effects.

Question 7

Monitoring

Answer 7

• Methotrexate concentration
• Complete blood count
• Renal and liver function
• patients for symptoms of pneumonitis
• Liver biopsy