Methotrexate

Question 1

how does methotrexate work

Answer 1

an anti-metabolite which inhibits dihydrofolate reductase

Question 2

what two drugs should you avoid prescribing at the same time as methotrexate

Answer 2

trimethoprim

cotrimoxazole

Question 3

give some potential side effects of methotrexate

Answer 3

hepatic cirrhosis
interstitial pneumonitis
severe myelosuppression
pulmonary fibrosis
mucositis

Question 4

how often should you monitor bloods for paitents on methotrexate

Answer 4

weekly until treatment stabilised than every 2-3 months

Question 5

what is the advice re: pregnancy and methotrexate

Answer 5

women should avoid pregnancy for at least six months after treatment has been stopped

Question 6

what should be co-prescribed with methotrexate

Answer 6

folic acid

Question 7

when should patients take folic acid

Answer 7

x1 weekly, taken >24hours after methotrexate dose

Question 8

what are three indications for methotrexate

Answer 8

• inflammatory arthritis
• psoriasis
• some chemotherapy for ALL

Question 9

what is the treatment of choice for methotrexate toxicity

Answer 9

folinic acid

Question 10

what drug increases the chances of methotrexate toxicity

Answer 10

high dose aspirin