OncoPharm Methotrexate
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May 4, 2018 Dive into the fascinating journey of methotrexate, from its origins as an antifolate to a cornerstone in chemotherapy. Discover its mechanisms, dosing intricacies, and safety measures vital for treating acute lymphoblastic leukemia and other conditions. This exploration highlights how this once-simple drug has evolved into a crucial player in modern oncology, showcasing its lasting impact on patient care.
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Methotrexate's Historic Significance
- Methotrexate marks the birth of modern chemotherapy, initially emerging in the late 1940s.
- It works by inhibiting dihydrofolate reductase, crucial for DNA replication in rapidly growing cells.
Methotrexate Cell Entry and Retention
- Methotrexate enters cells through an active pump and gets polyglutamated inside cancer cells.
- This polyglutamation boosts drug retention and affinity for its target, increasing its effectiveness.
Urine Alkalinization for Safety
- Always alkalinize urine to pH ≥ 7 and maintain urine output over 100 mL/hour during high-dose methotrexate.
- Use IV fluids with sodium bicarbonate or consider acetazolamide if alkalinization is challenging.