Which would the nurse expect to administer to counteract the effects of methotrexate?
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Methotrexate is a drug used to treat rheumatoid arthritis (RA) and other inflammatory conditions. Nearly 60% of all rheumatoid arthritis patients are currently on or have been on methotrexate. Methotrexate is recommended as the first treatment for RA by the American College of Rheumatology. Methotrexate is taken ONCE A WEEK. You will choose a day of the week, for example Saturday. You will then take your methotrexate every Saturday. The pills are 2.5mg each and the usual dose is 3 to 10 pills. Follow your rheumatologist’s directions. Do not take more or less medicine than ordered. This medicine can be taken with or without food. You should also take 1mg of folate (folic acid) each day. Your rheumatologist will prescribe the folic acid. This will
help prevent side effects. Methotrexate can cause mouth ulcers in a few patients, in the beginning of treatment. This should go away with time. Another possible side effect is nausea and vomiting. Methotrexate can also cause hair thinning or hair loss. In rare cases some people may develop lung problems. Methotrexate can cause mild liver irritation. Please tell your doctor if you have a history of any alcohol abuse, hepatitis, yellow jaundice,
or liver disease. While on methotrexate you must limit yourself to 2 alcoholic beverages per week. Blood work will be done every 4-12 weeks to check your liver function. This blood work will also include a complete blood count (CBC) since methotrexate can also cause a decrease in blood counts. This blood work is very important. It allows the rheumatologist to make timely changes to your dose of methotrexate if there is ever problem. Methotrexate is known to cause birth
defects in the children of both men and women taking this drug. If you are pregnant, considering having a child, or nursing, discuss this with your rheumatologist before beginning this medication. You must use an effective form of birth control while taking methotrexate and for at least 3 months after the methotrexate is stopped. Your rheumatologist or nurse can give you additional guidance. When you are taking methotrexate, it is
very important that your doctors know if you are taking any other medicine. This includes prescription and non-prescription medicines as well as birth control pills, vitamins, and herbal supplements. Methotrexate can be taken with other medications. You should not take methotrexate while taking antibiotics containing trimethoprim-sulfa (Bactrim®, Sulfatrim®, etc…). If you are prescribed one of these medications for an infection, do not take your methotrexate that week. Always call your health care provider if you have any questions or concerns. Methotrexate for ectopic pregnancyCare instructionsWhat is methotrexate?Methotrexate is a type of medicine that stops cells from dividing. It can be used as a way (other than surgery) to treat a pregnancy that’s implanted outside the uterus (ectopic pregnancy). It’s given by injection, and usually just 1 dose is given. You will need to have blood tests to monitor the level of pregnancy hormone in your blood. The methotrexate will stop the pregnancy. The level of pregnancy hormone in your blood should decrease over 2 to 4 days. Based on your blood test results, your doctor will tell you if you need another injection of methotrexate. What will happen after you get methotrexate?After you get methotrexate, you may have:
Your doctor will likely want you to have a blood test 2 to 3 times a week, for 2 to 3 weeks. This is to see if the methotrexate worked to stop the pregnancy. What you need to know about this medicineSide effects of methotrexate may include:
How can you care for yourself at home?If you have nausea, sip clear fluids like ginger ale or soup broth. Try to drink often and eat small amounts of dry, starchy food (like soda crackers or dry toast) every 15 minutes. To help prevent mouth sores:
If you need to take pain medicine for symptoms like headache or cramping, you can take acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). For 2 days after getting methotrexate, it’s best to take acetaminophen. If the acetaminophen doesn’t help, you can take ibuprofen unless your doctor tells you not to or if you have kidney problems. If you have any questions about medicine, talk to your healthcare provider or pharmacist. To help relax the muscles that cause cramping, you can use a hot water bottle or a heating pad. Make sure you put a cloth between your skin and the heat, so you don’t get a burn. Taking hot baths can also help. When should you call for help?Call 911 if you have:
Call your doctor or nurse call line (811 in most provinces or territories) now if you have:
What you need to know when you get this medicineYou must not get pregnant for at least 3 months after having a methotrexate injection. If you’re sexually active, you will need to use a reliable method of birth control. Talk to your doctor or healthcare provider if you have questions about birth control. Washing your hands with soap and water after you go to the bathroom is important. Methotrexate can make your immune system weaker, which means it’s harder for your body to fight infections. After getting methotrexate, do not have:
After getting methotrexate, do not take:
To see this information online and learn more, visit MyHealth.Alberta.ca/health/pages/conditions.aspx?Hwid=custom.ab_pregnancy_ectopic_methotrexate_inst. For 24/7 nurse advice and general health information call Health Link at 811. Current as of: May 5, 2022 Author: Emergency Medicine, Alberta Health Services This material is not a substitute for the advice of a qualified health professional. This material is intended for general information only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use. What safety measures with the nurse include when administering methotrexate?For 48 hours after this drug is given, the patient's body fluids can contain the drug. During that 48-hour period, caregivers should follow safety guidelines when handling the patient's vomit, blood, urine, and bowel movements, including diapers. These guidelines include wearing gloves when cleaning up body fluids.
Which agent would be classified as an immune stimulant?Immune stimulants include interferons, interleukins, and colony-stimulating factors (utilized to stimulate bone marrow to produce more white blood cells especially for patients at serious risk for infection).
What measure protects the nurse when preparing cytotoxic drugs?Workers at risk of exposure should wear a protective gown and 2 pairs of gloves when unpacking and cleaning cytotoxic drugs, from the opening of the external packaging to the placing of the secondary or primary packaging (or both) in their storage space.
What would the nurse recognize as the primary goal s of highly active antiretroviral therapy Haart )?The primary goal of antiretroviral therapy (ART) is to prevent HIV-associated morbidity and mortality. This goal is accomplished by using effective ART to achieve and maintain a plasma HIV-1 RNA (viral load) below the quantification limits of commercially available assays.
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