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The flashcards below were created by user
ch.tyrrell
on FreezingBlue Flashcards.
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What is the MOA of methotrexate
blocks dihydrofolate reductase which blocks actions of folic acid
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Describe the pharmacokinetics of methotrexate
- A: 100% bioavailable; saturable
- D: multi-compartmental
- M: minimal
- E: predominately renal
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What are the uses of methotrexate?
- 1. oncology related: leukemias, lymphomas, etc.
- 2. non-oncologic uses: RA, servere psoriasis, etc.
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What are the methotrexate rescue therapy options?
- Leucovorin (folinic acid)
- Glucarpidse (Voraxaze)
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What is leucovorin and how does it work?
- Methotrexate rescue therapy
- Restores folate stores needed for purine/pyrimidine sythesis
- Given with high-dose methotrexate regimens to help prevent toxicities
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What is Glucarpidase and how does is work?
- Methotrexate rescue therapy
- Converts methotrexate to inactive metabolites
- Indicated when methotrexate concentration is in toxic range, specifically for patients w/ impaired renal function
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If administered together, how far apart should Leucovorin and Glucarpidase be separated?
Leucovorin should not be administered within 2 hours of Glucarpidase.
Glucarpidase will break down leucovorin b/c it is structurally similar
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What is the goal of therapeutic drug monitoring (TDM) for methotrexate?
To prevent methotrexate toxicity
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What is the MOA of busulfan?
An alkylating agent that binds to DNA and prevents it from replicating and moving forward
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What are the uses of busulfan?
- leukemia
- conditioning regimen for hematopoietic stem cell transplant
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What is the goal of TDM for bsulfan?
to maintain therapeutic concentration
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What is the risk associated with supratherapeutic concentrations of busulfan?
liver injury = sinusoidal obstruction syndrome (veno-occlusive disease)
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