Drug Methotrexate

Action Classification/ Action: Antimetabolite, Antineoplastic, Antipsoriatic, Antirheumatic Mechanism of Action: Inhibits dihydrofolic acid reductase, leading to inhinbition of DNA synthesis and inhibition of cellular replication; selectively affects the most rapidly dividing cells.

Indication Treatment of gestational choriocarcinoma, chorioadenoma destruens, hytidiform moles. Symptomatic control of severe, recalcitrant disabling psoriasis.

Contraindication Contraindicated with pregnancy, lactation, alcoholism, chronic liver disease, immune deficiencies, blood dyscrasias, hypersensitivity to methotrexate.

Adverse Effect CNS: drowsiness, headache, dizziness, blurred vision, aphasia, hemiparesis, paresis, seizures, fatigue, malaise.

NSG. Responsibilities

Arrange for tests to evaluate CBC, urinalysis, renal and liver function tests, and X-ray before therapy, during therapy and several GI: Ulterative weeks after therapy; stomatitis, gingivitis, severe toxicity could pharyngitis, anorexia, occur. nausea, vomiting, Ensure patient is not diarrhea, pregnant before hematemesis, melana, administering drug. GI ulceration and Reduce dosage or bleeding, enteritis, discontinue of renal hepatic toxicity. failure occurs. Arrange leucovorin GU: Renal Failure, or levoleucovorin effects on fertility readily available as (defective oogenesis, antidote for defective methotrexate spermatogenesis, overdose or when transient large doses are used. oligospermia, Tell the patient to menstrual avoid NSAIDs and dysfunction, infertility, alcohol; serious side abortion, fetal defects effects may occur. )

Hematologic: Severe bone marrow depression, increased susceptibility to infection. Hypersensitivity: Anaphylaxis, sudden death Respiratory: Interstitial pneumonitis, chronic interstitial obstructive pulmonary disease Other: Chills and fever, metabolic changes (diabetes, osteoporosis), cancer.