University of Ghana Medical School, Department of Medicine and Therapeutics, Accra, Ghana.
Korle Bu Teaching Hospital, Department of Medicine and Therapeutics, Accra, Ghana.
Ghana Med J. 2020 Mar;54(1):68-71. doi: 10.4314/gmj.v54i1.10.
The use of methotrexate in routine clinical practice is becoming more common among specialties such as rheumatology, dermatology, oncology and obstetrics. General clinicians are increasingly encountering patients on this drug. Though it has a high safety profile, there is a recognised risk of acute toxicity or long-term complications associated with its use, which can be worsened by several factors such as advanced age, moderate to severe renal impairment, low folate level and/or inadequate folate supplementation, hypoalbuminaemia, polypharmacy causing drug-drug interactions and wrongful administration. We present a case of a 45-year old woman with rheumatoid arthritis who presented with acute pancytopaenia and mucositis due to methotrexate toxicity. We highlight its peculiar dosing regimen to minimise prescribing errors.
None.
甲氨蝶呤在风湿科、皮肤科、肿瘤科和妇产科等专业领域的常规临床实践中应用越来越多。普通临床医生越来越多地遇到使用该药的患者。尽管甲氨蝶呤安全性高，但已知其使用存在急性毒性或长期并发症的风险，这些风险可因多种因素而加重，如高龄、中重度肾功能不全、叶酸水平低和/或叶酸补充不足、低白蛋白血症、药物相互作用导致的多种药物并用和错误给药。我们报告了 1 例 45 岁类风湿关节炎女性患者，因甲氨蝶呤毒性出现全血细胞减少和黏膜炎。我们强调了其特殊的给药方案，以尽量减少处方错误。
无。
