ยา Methotrexate

🔬 Essential Information of Methotrexate

Types of drugs:

📍 immunosuppressant.

📍 anticancer (Antimetabolite - folic acid antagonist)

Indications:

- Cancer (e.g. acute lymphoblastic leukemia, lymphoma, breast cancer)

- Rheumatoid arthritis

- Psoriasis

- Ectopic pregnancy treatment

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👩‍⚕️ The role of nurses in the care of patients using Methotrexate.

1. Before giving medicine

- Check the indications: which diseases are used to treat (because the dose is very different).

- Examination of liver and kidney function: such as AST, ALT, Cr, BUN before starting the drug.

- CBC check: to see white, red and platelet levels.

- Pregnancy check (if the patient is a woman of childbearing age): because MTX is a teratogenic drug, causing the baby to be maimed or miscarried.

- Teach patients to understand that MTX is a drug that requires high precaution.

2. While giving medicine

- Medication according to the treatment plan: may be administered orally, injected or intramuscularly (depending on the identification).

- Prevent allergies: Observe allergies or adverse reactions during administration.

- Do not administer drugs in combination with NSAIDs, Trimethoprim, or drugs affecting the kidney or blood formation unless the doctor considers them appropriate.

3. After giving medicine

- Follow up with side symptoms: e.g. fatigue, anorexia, vomiting, sore mouth, rash

- Regularly check CBC and LFT for bone marrow and liver poisoning.

- Provide advice on preventing drug harm: Avoid sun, don't drink alcohol, prohibit unprotected sex while using drugs.

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🚨 Common side symptoms

1.Press bone marrow → low blood cell

2. There is an ulcer in the mouth. Mucositis.

3. Nausea, vomiting, anorexia

4. Liver poisoning (hepatotoxicity)

5. Hair loss

6. Skin allergic rash

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💊 Nursing when drug poisoning occurs.

✔️ use Leucovorin as a rescue to reduce MTX poisoning (especially in high-dose chemotherapy).

✔️ closely follow up lab results: specifically, CBC and liver function.

Hydration and Alkalinization of urine to reduce kidney failure risk from MTX

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💬 Advice the nurse should give to the patient.

▫️ prohibit the use of antiinflammatory drugs or other drugs without consulting a doctor.

▫️ should use strict contraception during drug use, and after discontinuation at least 3 months (men) or 6 months (women).

▫️ get a blood test by appointment.

▫️ if there are symptoms such as fever, sore throat, abnormal bleeding, or rash, need to notify the doctor.

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📌 Trick remember for nurses

> M-E-T-H-O

M: Mouth sore (sore mouth)

E: Elevated LFT (Liver poisoning)

T: Teratogenic (Do not use while pregnant)

H: Hematologic suppression (bone marrow press)

O: Observe for toxicity (poison must be monitored)

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