Saturday, October 3, 2009
Methotrexate rheumatoid arthritis
In the treatment of neoplastic diseases, Methotrexate should be continued only if the potential benefit warrants the risk of severe myelosuppression. In psoriasis and rheumatoid arthritis, Methotrexate should be stopped immediately if there is a significant drop in blood counts. In patients with malignancy and preexisting hematopoietic impairment, the drug should be used with caution, if at all. Methotrexate can suppress hematopoiesis and cause anemia, aplastic anemia, leukopenia, and/or thrombocytopenia. Methotrexate should be used with extreme caution in the presence of peptic ulcer disease or ulcerative colitis. If vomiting, diarrhea, or stomatitis occur, which may result in dehydration, Methotrexate should be discontinued until recovery occurs.
Friday, October 2, 2009
Rheumatoid Arthritis with methotrexate and prednisone
She developed a flare-up, so methotrexate was started nine months before she was admitted to the hospital, and naproxen was discontinued. The patient had had rheumatoid arthritis for 34 years and was maintained on naproxen and on prednisone , but was unresponsive to gold therapy. A case is reported of a 71-year-old woman who was receiving weekly treatments of methotrexate and who succumbed to pneumonia caused by Nocardia, a type of bacteria known to be highly infective in patients with deficient immune systems. Although serious side effects have occurred in these and other patients treated with the drug, its use is considered to be generally safe, as severe complications are rare. Low-dose methotrexate is frequently used to treat patients with rheumatoid arthritis who are unresponsive to other medications. Abstracts: Nocardia asteroides pneumonia complicating low dose methotrexate treatment of refractory rheumatoid arthritis.
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