scholarly journals Acute methotrexate toxicity in psoriasis

2019 ◽  
Vol 5 (3) ◽  
pp. 652
Author(s):  
Peram Karunakar ◽  
Venkateswara Rao Garimella ◽  
Chinmai Yerram ◽  
Anusha Gogula
Keyword(s):  
Bone Marrow ◽  
Plaque Psoriasis ◽  
Low Dose ◽  
Standard Treatment ◽  
Treatment Guidelines ◽  
Psoriasis Patient ◽  
Bone Marrow Suppression ◽  
Chronic Plaque Psoriasis ◽  
Dose Methotrexate ◽  
Standard Treatment Guidelines

<p align="left">We describe two cases of low dose methotrexate (MTX) toxicity in patients with psoriasis. Patient was a 49-year-old male, known case of chronic plaque psoriasis from 10 years on and off. He was advised to take MTX 2.5 mg 2 days a week but patient took 2.5 mg twice daily (BD) for 6 continuous days following which he developed ulceration over psoriatic plaques and bone marrow suppression. MTX is safe and effective if adhered to standard treatment guidelines but inadverent use may lead to it’s toxicity.</p>

scholarly journals Medication Usage Evaluation in Patients Prescribed with Ganciclovir in Bone Marrow Transplantation

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Kashif Ali ◽  
Fakhsheena Anjum ◽  
Mehwish Wajdi ◽  
Zubeda Bhutto ◽  
Rida Naseem ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Drug Interaction ◽  
Bone Marrow Transplantation ◽  
Clinical Pharmacist ◽  
Marrow Transplantation ◽  
Standard Treatment ◽  
Treatment Guidelines ◽  
Assessment Criteria ◽  
Oncologic Patients ◽  
Standard Treatment Guidelines

Background: Cytomegalovirus (CMV) is one of the leading risks in bone marrow transplantation for which Ganciclovir is choice of therapy requiring monitoring due to its cytotoxic potential. Study objectives: The aim of this study was to assess the use of Ganciclovir in the management of CMV in hemato-oncologic patients. Methods: The study was designed to assess the usage pattern of Ganciclovir in concordance with the predefined assessment criteria. The medical record of patients was extracted by a senior clinical pharmacist from the specialty of hematology-Oncology in a hospital located in Karachi, Pakistan. Patients’ records of 2016-2017 (24 months) were collected both retrospectively and prospectively to review with CMV positive infection; the nurses’ performance regarding drug storage, handling, and preparation for administration was also observed. Assessment criteria were developed to evaluate the appropriateness of Ganciclovir use by applying standard treatment guidelines adapted from the Lexicomp drug monograph specifying its usage details, USP 800 (United States Pharmacopeia) and NIOSH Guidelines The collected data were categorized and analyzed by using Statistical Package for Social Sciences software, version 16.0. Results: For this study, 42 cases with CMV positive infection were observed. Out of n= 42 cases, n= 23 (54.76%) had drug interaction with mycophenolate mofetil and n= 1 (2.38%) case had drug interaction with imipenem cilastatin. Ganciclovir was stopped in n= 8 (19.04%) patients due to development of adverse drug reaction (febrile neutropenia).  It was observed by the senior clinical pharmacist that neither the pharmacists nor the nurses were aware of protocol for Ganciclovir handling as per standard treatment guidelines. Conclusion: Ganciclovir was inappropriately managed by the Nurses and Pharmacists which can be improved by developing and implementing local guidelines according to standard protocol.

scholarly journals Acute Methotrexate Toxicity: A Fatal Condition in Two Cases of Psoriasis

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Pankti Jariwala ◽  
Vinay Kumar ◽  
Khyati Kothari ◽  
Sejal Thakkar ◽  
Dipak Dayabhai Umrigar
Keyword(s):  
Bone Marrow ◽  
Drug Interactions ◽  
Creatinine Level ◽  
Joint Pain ◽  
Low Dose ◽  
Skin Lesions ◽  
Bone Marrow Suppression ◽  
Intermittent Treatment ◽  
Self Medication ◽  
Dose Methotrexate

We describe two fatal cases of low dose methotrexate (MTX) toxicity in patients with psoriasis, emphasizing the factors that exacerbate MTX toxicity. The first patient was a 50-year-old male of psoriasis on intermittent treatment with MTX. After a treatment-free period of six months, he had self-medication of MTX along with analgesic for joint pain for one week which followed ulceration of the lesions, bone marrow suppression, and eventually death. The second patient was a 37-year-old male of psoriasis, who has taken MTX one week earlier without prior investigations. He had painful ulcerated skin lesions and bone marrow suppression. On investigations, he showed high creatinine level and atrophied, nonfunctioning right kidney on ultrasonography. In spite of dialysis, he succumbed to death. MTX is safe and effective if monitored properly, but inadvertent use may lead to even death also. Prior workup and proper counseling regarding the drug interactions as well as self-medication should be enforced.

Severe Pancytopenia Following Single Dose Methotrexate In Psoriasis: A Rare And Potentially Lethal Manifestation

2020 ◽  
Vol 15 ◽  
Author(s):  
Ajeet Singh ◽  
Ritul Choudhary ◽  
Namrata Chhabra ◽  
Satyaki Ganguly ◽  
Vinay Rathore
Keyword(s):  
Single Dose ◽  
Plaque Psoriasis ◽  
Granulocyte Colony Stimulating Factor ◽  
Chronic Plaque Psoriasis ◽  
Toxic Side Effect ◽  
Plaque Erosion ◽  
Dose Methotrexate ◽  
History Of ◽  
Severe Pancytopenia ◽  
Stimulating Factor

: Methotrexate is an antimetabolite anticancer drug frequently used in the treatment of extensive chronic plaque psoriasis. Psoriatic plaque erosion is a rare toxic side effect of single-dose methotrexate and is described as a sign of the impending pancytopenia. Here, we report a case of a 48-year-old male, presented with multiple oral and genital erosions, fissuring over palm and soles for 5 days. His laboratory tests revealed severe pancytopenia and nephropathy. He had a history of chronic plaque psoriasis for which he took a single dose of 15 mg methotrexate. During the hospital stay, the patient needed folate antagonist, granulocyte colony stimulating factor (G-CSF), intravenous fluids, blood transfusions, and platelet transfusions. He recovered within 12 days of admission.

scholarly journals Changes to the ART guidelines – an overview

2010 ◽  
Vol 11 (1) ◽  
Author(s):  
Celicia Serenata
Keyword(s):  
Antiretroviral Therapy ◽  
South African ◽  
Standard Treatment ◽  
Treatment Guidelines ◽  
Dual Therapy ◽  
National Standard ◽  
Child Transmission ◽  
Task Team ◽  
Standard Treatment Guidelines ◽  
Mother To Child

In 2009 the South African National AIDS Council (SANAC) Treatment Technical Task Team (TTT) finalised recommendations for changes to the national standard treatment guidelines for adult and paediatric management and treatment, as well as changes in the prevention of mother-to-child transmission of HIV (PMTCT) guidelines, moving away from monotherapy to dual therapy. President Zuma announced changes in the national antiretroviral therapy (ART) programme on World AIDS Day 2009. Subsequently additional changes were made to the treatment guidelines to be in line with these new Presidential mandates, which came into effect on 1 April 2010.

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