Methotrexate: instruction, and the use of formula
Mode of action – antineoplastic, cytostatic, immunosuppressive.
It inhibits dihydrofolate reductase (DGF), which converts dihydrofolate tetrahydrofolic
The nosological classification
C00-C14 Malignant neoplasms of lip, oral cavity and pharynx
C15-C26 Malignant neoplasms of digestive organs
C16 Malignant neoplasm of stomach
C30 Malignant neoplasm of nasal cavity and middle ear
C30-C39 Malignant neoplasms of respiratory and chest
C31 Malignant neoplasm of accessory sinuses
C32 Malignant neoplasm of the larynx
Methotrexate is an antimetabolite used to treat certain types of cancer
C34 Malignant neoplasm of bronchus and lung
C40 Malignant neoplasm of bone and articular cartilage of limbs
C41 Malignant neoplasm of bone and articular cartilage of other and unspecified sites (osteosarcoma, osteogenic carcinoma)
C44 Other malignant neoplasms of skin
C45-C49 Malignant neoplasms of mesothelial and soft tissue
C49 Malignant neoplasm of other types of connective and soft tissue
C50 Malignant neoplasm of breast
C53 Malignant neoplasm of the cervix
C54 Malignant neoplasm of corpus uteri
C56 Malignant neoplasm of ovary
C58 Malignant neoplasm of placenta
C62 Malignant neoplasm of testis
C67 Malignant neoplasm of bladder
C69.2 Malignant neoplasm of the retina
C71 Malignant neoplasm of brain
C76.0 Malignant neoplasm of head, face and neck
C81 Hodgkin’s disease [lymphoma]
C81-C96 Malignant neoplasms of lymphoid, haematopoietic and related tissue
C82 Follicular [nodular] non-Hodgkin’s lymphoma
C83 Diffuse non-Hodgkin’s lymphoma
Large-C83.3 (diffuse) non-Hodgkin lymphoma
C83.7 Burkitt’s tumor
C84.0 Mycosis fungoides
C84.1 SĂ©zary’s disease
C85 Other and unspecified types of non-Hodgkin’s lymphoma
C91.0 Acute lymphoblastic leukemia
M06.9 Rheumatoid arthritis, unspecified
Application of the Methotrexate
Horionkartsinoma uterus, acute lymphocytic leukemia, central nervous system tumors (leukemoid infiltration of the meninges), breast cancer, head and neck cancer, lung cancer, bladder, stomach; Hodgkin’s disease, non-Hodgkin’s lymphoma, retinoblastoma, osteosarcoma, Ewing’s sarcoma, soft tissue sarcoma; refractory psoriasis (only when the diagnosis in case of resistance to other forms of therapy), rheumatoid arthritis.
Hypersensitivity, immune deficiency, anemia (including hypo-and aplastic), leukopenia, thrombocytopenia, leukemia with hemorrhagic syndrome, liver or kidney failure.
Infectious diseases, ulcers of the mouth and digestive tract, recently transferred operations, gout or renal calculi in the history of (risk of hyperuricemia), the elderly and children’s age.
From the nervous system and sensory organs: encephalopathy (especially with the introduction of multiple doses of intrathecal as well as in patients after brain irradiation), dizziness, headache, blurred vision, drowsiness, aphasia, back pain, muscle stiffness back of the neck, convulsions, paralysis, hemiparesis; in some cases – fatigue, weakness, confusion, ataxia, tremors, irritability, coma; conjunctivitis, excessive lacrimation, cataract, photophobia, cortical blindness (at high doses).
Cardio-vascular system (blood, hemostasis): anemia, leukopenia, thrombocytopenia, neutropenia, lymphopenia (particularly T-lymphocytes), hypogammaglobulinemia, hemorrhage, septicemia due to leukopenia; rarely – pericarditis, pericardial effusion, hypotension, thromboembolic changes (arterial thrombosis, cerebral thrombosis, deep vein thrombosis, renal vein thrombosis, thrombophlebitis, pulmonary embolism).
From the respiratory system: rarely – interstitial pneumonitis, pulmonary fibrosis, exacerbation of pulmonary infections.
From the digestive tract: gingivitis, pharyngitis, ulcerative stomatitis, anorexia, nausea, vomiting, diarrhea, difficulty swallowing, melena, ulceration of the gastrointestinal mucosa, gastrointestinal bleeding, enteritis, liver damage, fibrosis and cirrhosis of the liver (the probability is increased in patients receiving continuous or long-term therapy).
With the genitourinary system: cystitis, nephropathy, azotemia, hematuria, or severe hyperuricemia nephropathy, dysmenorrhea, unstable oligospermia, violation of oogenesis and spermatogenesis process, fetal defects.
For the skin: skin erythema, itching, hair loss (rarely), photosensitivity, ecchymosis, acne-like rash, abrasions, peeling, de- or hyperpigmentation of the skin, blisters, folliculitis, telangiectasia, toxic epidermal necrolysis, Stevens – Johnson.
Allergic reactions: fever, chills, rash, hives, anaphylaxis.
Other: immunosuppression, rarely – opportunistic infections (bacterial, viral, fungal, protozoal), osteoporosis, vasculitis.
Pregnancy and breast-feeding
Contraindicated during pregnancy (may cause fetal death or cause birth defects).
Category effects on the fetus by FDA – X.
At the time of treatment should stop breastfeeding.