Oncology

Methotrexate

Leave a Comment / Oncology, Rheumatology /
Methotrexate1
Methotrexate2
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Hi! Meet ‘Mezzo’ (aka methotrexate). He is used to treat aches from various cancers and RA. He is widely popular being one of the top 200 drugs used in the United States but don’t let him fool you, he can pack quite a punch. ⁠
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☝🏻 You need him at higher doses if you’re treating cancer but low doses can be used in severe cases of rheumatoid arthritis. ⁠
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‼️ A lot of collateral damage (toxic side effects) can occur when he is around such as bone marrow suppression and liver damage can be found. ⁠
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🌟 Last but not least, make sure to educate your patients completely about the appropriate dosing schedule of once-weekly. ⁠

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IV chemotherapy agents with high emetic risks⁠

Leave a Comment / Oncology /
🌟 Chemotherapy agents are notorious for causing many side effects such as nausea and vomiting and are classified according to their emetic risk. 🤢🤮⁠ ⁠ 🌟 High-risk agents cause emesis in more than 90% of patients and require pre-treatment with medications such as 5HT3 antagonists (ex: ondansetron), neurokinin-1 receptor antagonists (ex: aprepitant), and dexamethasone. ⁠ ⁠ 🧠 A fun way to learn which IV chemotherapy agents have high emetic risk – think of this story: ⁠ ⁠ ‘The car had motion sickness and threw up, making splat sounds”⁠ ⁠ 🤔 Can you imagine it in your head? This story will help you remember the medications DACARbazine, Mechlorethamine, Streptozotocin, and ciSPLATin. ⁠ ⁠ 🌟 Other IV chemotherapy agents that have high emetic risk at higher doses or in combination with other medications include:⁠ ⁠ -Carboplatin AUC>4⁠ -Carmustine >250 mg/m2⁠ -Cyclophosphamide >1500 mg/m3⁠ -Doxorubicin >60 mg/m2⁠ -Epirubicin >90 mg/m2⁠ -Ifosfamide >2 g/m2/dose⁠ -AC (any combo that contains an anthracycline + cyclophosphamide)

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