[Managing methotrexate toxicity: a case report].
High-dose methotrexate is included in chemotherapy regimens used to treat a number of malignant neoplasms. Methotrexate plasma concentration is considered the best toxicity predictor. Monitoring methotrexate plasma concentrations is standard practice in the identification of at-risk patients, the titration of folinic acid doses, and the establishment of corrective measures. Methotrexate is a kidney-cleared weak acid, and renal function impairment may retard methotrexate clearance. A case of severe methotrexate-induced toxicity secondary to renal failure is reported in a patient with non-Hodgkin s lymphoma receiving methotrexate at a dose of 1 g/m2. Corrective measures included folinic acid rescue therapy, cholestyramine resin administration, hydration and urine alkalinization, urine pH monitoring, and extracorporeal clearance techniques.
Fernández Megía
M J
MJ
Servicio de Farmacia, Hospital Virgen de la Luz, Cuenca.
Alós Almiñana
M
M
Terol Castera
M J
MJ
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D000368:Aged; D000837:Anion Exchange Resins / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D002792:Cholestyramine Resin / Q000008:administration & dosage; D006801:Humans; D006863:Hydrogen-Ion Concentration; D002955:Leucovorin / Q000627:therapeutic use; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D016896:Treatment Outcome
D000837:Anion Exchange Resins; D000964:Antimetabolites, Antineoplastic; D002792:Cholestyramine Resin; D002955:Leucovorin; D008727:Methotrexate