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Generic Name Pharmacologic Class General Indications Concentrations CNS: Headache, drowsiness, Before

Methotrexate Folic acid antagonist Inhibits folic acid reductase, - Burkitt's lymphoma - Pregnancy blurred vision, aphasia, - Observe 15 rights in drug
leading to inhibition of DNA - Acute lymphoblastic - Lactation hemiparesis, paresis, seizures, administration.
Trade Name Therapeutic Class synthesis and inhibition of cellular leukaemia - Alcoholism fatigue, malaise, dizziness - Assess for contraindications of the
Folex Antimetabolite. replication; selectively affects the - Choriocarcinoma - Chronic liver disease Dermatologic: Erythematous drug.
Antineoplastic, most rapidly dividing cells - Mycosis fungoides - Immune deficiencies rashes, pruritus, urticaria, - Arrange for tests to evaluate CBC,
Minimum Dose Antipsoriatic, (neoplastic and psoriatic cells) - Psoriasis - Blood dyscrasias photosensitivity, urinalysis, renal and liver function tests,
7.5 mg 1 tab BID Antirheumatic - Rheumatoid arthritis - Hypersensitivity depigmentation, alopecia, and chest X-ray before therapy.
Pharmacokinetics - Crohn's disease ecchymosis, telangiectasia, - Ensure that patient is not pregnant
Precaution
Maximum Dose Pregnancy Risk - Osteosarcoma acne, furunculosis before administering.
- Renal disease
15 mg 1 tab q6˚ Factor A: Rapidly absorbed from the GI - Breast cancer - Infection
GI: Ulcerative stomatitis, - Prepare a calendar of treatment days
X tract at low doses, higher doses - Advanced gingivitis, pharyngitis, anorexia,
- Peptic ulcer
Contents are less well absorbed. Rapidly lymphosarcoma nausea, vomiting, diarrhea, During
- Ulcerative colitis
Methotrexate and completely absorbed after IM - Acute lymphoblastic hematemesis, melena, GI - Arrange for tests to evaluate CBC,
- Debility
doses. leukaemia ulceration, bleeding, enteritis, urinalysis, renal and liver function tests,
Availability and D: Tissues and extracellular fluids; - Choriocarcinoma hepatic toxicity and chest X-ray during therapy.
Drug interaction
color crosses the blood-brain barrier - Acute lymphoblastic GU: Renal failure, effects on - Do not administer any other
Drug to drug
- Tablets- 2.5, 5, 7.5 and placenta; enters breast milk. leukaemia fertility medications containing alcohol.
- Potentially serious to
10, 15mg
Small amounts in saliva and - Mycosis fungoides Hematologic: Severe bone - Arrange for adequate hydration during
- Powder for injection- fatal reactions when
breast milk. 50% bound to plasma - Crohn's disease marrow depression, increased therapy to reduce risk of hyperuricemia.
20 mg, 1 g per vial given with NSAID’s
- Injection- 25 mg/mL proteins. Bound as polyglutamate - Psoriasis susceptibility to infection - Arrange to have leucovrin readily
- Risk for toxicity with
conjugates, bound drug may - Meningeal leukaemia Hypersensitivity: available as antidote for methotrexate
Routes of alcohol
remain in the body for several - Hydatidiform mole Anaphylaxis, sudden death overdose.
administration - Increased risk of
mth, particularly in the liver. Respiratory: Interstitial - Instruct to use contraceptives during
Oral toxicity with salicylates,
M: Partly by intestinal flora. Does pneumonitis, chronic interstitial therapy.
Intramuscular probenecid,
not undergo significant obstructive pulmonary disease
Intravenous sulfonamides
metabolism at low dose therapy; Other: Chills and fever, After
- Decreased serum
7-hydroxy metabolite is detected metabolic changes, cancer - Arrange for tests to evaluate CBC,
levels and therapeutic
at high-doses. urinalysis, renal and liver function tests,
effects of digoxin
E: Primarily via urine; small and chest X-ray several weeks after
- May decrease
amounts in bile, feces. therapy.
theophylline clearance
- Instruct to report black tarry stools,
Route Onset Peak Duration fever, chills, sore throat, unusual
Drug to food
bleeding or bruising, cough or shortness
Oral Varies 1-2 hr Unknown - none reported
of breath, darkened or bloody urine,
IM Rapid 0.5-1 Unknown
abdominal, flank or joint pain, jaundice
hr symptoms, mouth sores.
IV Rapid 0.5-1 Unknown - Arrange for an antiemetic if nausea an
hr vomiting is severe.
- Reduce dosage or discontinue if renal
Drug Half Life failure occurs.
3-15 hr - Arrange for frequent, regular medical
check-ups.
Source: Source: Source: Source: Source: Source: Source:
Karch, Amy: 2009 http://www.keele.ac.uk/ http://mims.com.ph/, Karch, Amy: 2009 http://mims.com.ph/ Karch, Amy: 2009 Lippincott’s Karch, Amy: 2009 Lippincott’s Nursing Karch, Amy: 2009 Lippincott’s Nursing Drug Guide,
Lippincott’s Nursing Karch, Amy: 2009 Lippincott’s Lippincott’s Nursing Drug Guide, p. 768 Nursing Drug Guide, p. 769 Drug Guide, p. 769 p. 769
Drug Guide, p. 767-768 Nursing Drug Guide, p. 767