Clinical meaning
Methotrexate is a folate antagonist used in autoimmune conditions, certain cancers, and ectopic pregnancy. It inhibits cell division by blocking folic acid metabolism. understanding safe handling, side effect monitoring, and timely reporting of abnormal findings is critical for patient safety.
Exam relevance
Risk factors: - Renal impairment (delayed drug clearance) - Hepatic disease - Pre-existing bone marrow suppression - Concurrent NSAID use (increases methotrexate toxicity) - Alcohol use (hepatotoxicity risk) - Immunocompromised state - Elderly patients - Dehydration
Diagnostics: - Monitor CBC results for signs of myelosuppression (low WBC, low platelets, low RBC) - Monitor liver function test results as reported - Assess for signs of infection (fever, sore throat, malaise) - Monitor oral cavity for stomatitis and mucositis - Assess for signs of bleeding (bruising, petechiae, blood in stool/urine) - Monitor intake and output