Pharmaceutical care on a child patient with delay excretion of methotrexate
TAO Xing-ru
CHEN Hai-yan
Abstract：One 10-year-old boy was admitted to hospital for acute lymphoblastic leukemia for more than 2 months. After admission, high-dose methotrexate treatment regimen was administered for chemotherapy. Hydration, alkalization, antiemetic, hepatic protectants and calcium leucovorin were given for symptomatic therapy. On the second day of chemotherapy, the patient appeared poor appetite, nausea, frequent vomit, abdominal pain and diarrhea, headache, dizziness, joint pain and lumbar muscular pain. Clinical pharmacists participated in the whole treatment process. Through monitoring blood concentration of methotrexate and combining with state of the patient, delay excretion of methotrexate was considered to be the cause of the adverse reactions above. Clinical pharmacists proposed to continue antiemetic, increase the amount of hydration and alkalization, increase the calcium leucovorin dose and further monitor the plasma concentration of methotrexate in order to suit the remedy for the case. After the therapy, the patient was discharged with stable. The case suggested that blood concentration of methotrexate should be monitored when high-dose chemotherapy was used. We ought to adjust the dosage of calcium leucovorin according to the concentrations of methotrexate at 48 h and 72 h, in order to avoid the adverse drug reactions.
Keywords：MethotrexateDelay excretionAdverse drug reactionPharmaceutical care
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 21-23,39 )